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Journal of Affective Disorders
Journal Prestige (SJR): 2.053
Citation Impact (citeScore): 4
Number of Followers: 18  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0165-0327
Published by Elsevier Homepage  [3155 journals]
  • The effects of Toxic Early Childhood Experiences on Depression according
           to Young Schema Model: A Scoping Review
    • Abstract: Publication date: 1 March 2019Source: Journal of Affective Disorders, Volume 246Author(s): Charmaine Ruling Lim, Joanna Barlas BackgroundYoung Schema Model (YSM) emphasizes Toxic Early Childhood Experiences (TECE) as vulnerability factors to depression. However, the lack of consensus on how to define and measure TECE is likely to have led to inconsistent findings in current literature. This review maps supported and unsupported pathways to depression and measures used.MethodsA scoping review was conducted in accordance with the Joanna Briggs Institute protocol to identify primary research studies that examined developmental and maintenance pathways to depression within the YSM framework. 2463 articles were identified with 49 primary research studies selected for inclusion. As a subset of the overall review, this paper focuses on the 14 studies that examined effects of TECE on depression in context of YSM.ResultsThe studies used 11 different measures to examine the role of TECE in depression. Effects of maltreatment (i.e., physical abuse, emotional abuse, emotional neglect,) and perceived parenting (i.e., low care, high rejection, high overprotection and/or control, maladaptive parenting styles) on depression are well supported. Effects of sexual abuse and physical neglect on depression are currently inconclusive.ConclusionIn conclusion, findings revealed the inconsistent definition and measurement of TECE (with 11 different measures) in current literature. Findings support the effects of physical abuse, emotional abuse, emotional neglect, low care, high rejection, high overprotection and/or control, and maladaptive parenting styles on depression. Limitations of existing studies include researchers’ inconsistent definition and measurement of TECE, under-examined TECE sub-constructs, possible moderating relationships, predominant cross-sectional design, and homogeneous sampling. Limitations of the scoping review include its small number of studies and the absence of evaluation of the measures used. Nevertheless, this review represents the first step in the systematic examination of the empirical basis of YSM and is an important contribution to depression treatment and innovation.
  • Socio-demographic and psychological risk factors for suicidal behavior
           among individuals with anorexia and bulimia nervosa: A systematic review
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Amit Goldstein, Yari Gvion ObjectiveSuicide is the second leading cause of death among individuals with anorexia nervosa (AN) and is also elevated in bulimia nervosa (BN). We carried out a systematic review in which we analyzed the relationship between AN and/or BN and suicidality (i.e. suicidal ideation or attempted and/or death by suicide) and the major risk factors for suicidal behavior among AN and BN patients by synthesizing the qualitative data from relevant studies.Evidence acquisitionAccording to PRISMA guidelines, we conducted a systematic search of the literature on PsycNET, PubMed, Google Scholar, and ScienceDirect. Search terms were “eating disorders” “OR” “anorexia” “OR” “bulimia” combined with the Boolean “AND” operator with “suicide.”Evidence synthesisThe initial search identified 8,590 records, of which 38 research reports met the predefined inclusion criteria and were analyzed. Eating disorders (EDs) were found to be associated with a marked increase in suicidal behaviors and ideation. ED type, impulsivity, and specific interpersonal features were associated with suicidal behavior.ConclusionsOur findings highlight the importance of the combined role of socio-demographic and psychological factors to the co-occurrence of EDs and suicidal behavior. It is imperative that a thorough suicide assessment be conducted routinely for individuals with past and current EDs, and that clinicians be aware that this risk may be ongoing and occur throughout treatment, even after ED symptoms appear to be remitting.LimitationsStudy limitations include diagnostic definitions of and criteria for EDs, and the different terminology used by researchers to define suicide, including non-suicidal behaviors, which weakens the ability to draw conclusions regarding actual suicidal behaviors versus other self-harm behaviors.
  • Preliminary examination of gray and white matter structure and
           longitudinal structural changes in frontal systems associated with future
           suicide attempts in adolescents and young adults with mood disorders
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Elizabeth T. Cox Lippard, Jennifer A.Y. Johnston, Linda Spencer, Susan Quatrano, Siyan Fan, Anjali Sankar, Judah Weathers, Brian Pittman, Maria A. Oquendo, Hilary P. Blumberg BackgroundMood disorders are major risk factors for suicidal behavior. While cross-sectional studies implicate frontal systems, data to aid prediction of suicide-related behavior in mood disorders are limited. Longitudinal research on neuroanatomical mechanisms underlying suicide risk may assist in developing targeted interventions. Therefore, we conducted a preliminary study investigating baseline gray and white matter structure and longitudinal structural changes associated with future suicide attempts.MethodsHigh-resolution structural magnetic resonance imaging, diffusion tensor imaging, and suicide-related behavioral assessment data for 46 adolescents and young adults with mood disorders [baseline agemean = 18 years; 61% female] were collected at baseline and at follow-up (intervalmean = 3 years). Differences in baseline and longitudinal changes in gray matter volume and white matter fractional anisotropy in frontal systems that distinguished the participants who made future attempts from those who did not were investigated.ResultsSeventeen (37%) of participants attempted suicide within the follow-up period. Future attempters (those attempting suicide between their baseline and follow-up assessment), compared to those who did not, showed lower baseline ventral and rostral prefrontal gray matter volume and dorsomedial frontal, anterior limb of the internal capsule, and dorsal cingulum fractional anisotropy, as well as greater decreases over time in ventral and dorsal frontal fractional anisotropy (p 
  • Suicidal ideation and attempted suicide amongst Chinese transgender
           persons: National population study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Runsen Chen, Xuequan Zhu, Lucy Wright, Jack Drescher, Yue Gao, Lijuan Wu, Xin Ying, Ji Qi, Chen Chen, Yingjun Xi, Lanxin Ji, Huichun Zhao, Jianjun Ou, Matthew R. Broome BackgroundThis study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China.MethodsTransgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China.ResultsA total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models.LimitationsThe cross-sectional study design and lack of follow-up data are limitations of this study.ConclusionsThis is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population.
  • Altered mRNA expressions for N-methyl-D-aspartate receptor-related genes
           in WBC of patients with major depressive disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Chieh-Hsin Lin, Min-Wei Huang, Ching-Hua Lin, Chiung-Hsien Huang, Hsien-Yuan Lane ObjectiveMajor depressive disorder (MDD) is a complex mental disorder. The lack of well-established biomarkers hinders its diagnosis, treatment, and new-drug development. N-methyl-D-aspartate receptor (NMDAR) dysfunction has been implicated in the pathogenesis of MDD. This study examined whether expressions of the NMDAR-related genes are characteristic of MDD.MethodsExpressions of NMDAR-related genes including SRR, SHMT2, PSAT1, GCAT, GAD1, SLC1A4, NRG1 and COMT in peripheral WBCs of 110 patients with MDD (25 drug-naïve, 21 drug-free, and 64 medicated patients) and 125 healthy individuals were measured using quantitative PCR.ResultsThe mRNA expression levels of SRR, PSAT1, GCAT, GAD1, NRG1 and COMT were significantly different among the four groups (all p 
  • The role of neurotrophic factors in manic-, anxious- and depressive-like
           behaviors induced by amphetamine sensitization: Implications to the animal
           model of bipolar disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Samira S. Valvassori, Edemilson Mariot, Roger B. Varela, Daniela V. Bavaresco, Gustavo C. Dal-Pont, Camila L. Ferreira, Monica L. Andersen, Susannah J. Tye, João Quevedo BackgroundBipolar disorder (BD) and substance use disorders share common symptoms, such as behavioral sensitization. Amphetamine-induced behavioral sensitization can serve as an animal model of BD. Neurotrophic factors have an important role in BD pathophysiology. This study evaluated the effects of amphetamine sensitization on behavior and neurotrophic factor levels in the brains of rats.MethodsWistar rats received daily intraperitoneal (i.p) injections of dextroamphetamine (d-AMPH) 2 mg/kg or saline for 14 days. After seven days of withdrawal, the animals were challenged with d-AMPH (0.5 mg/kg, i.p) and locomotor behavior was assessed. In a second protocol, rats were similarly treated with d-AMPH (2 mg/kg, i.p) for 14 days. After withdrawal, without d-AMPH challenge, depressive- and anxiety-like behaviors were evaluated through forced swimming test and elevated plus maze. Levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin 3 (NT-3), neurotrophin 4/5 (NT-4/5) and glial-derived neurotrophic factor (GDNF) were evaluated in the frontal cortex, hippocampus, and striatum.ResultsD-AMPH for 14 days augmented locomotor sensitization to a lower dose of d-AMPH (0.5 mg/kg) after the withdrawal. d-AMPH withdrawal induced depressive- and anxious-like behaviors. BDNF, NGF, and GDNF levels were decreased, while NT-3 and NT-4 levels were increased in brains after d-AMPH sensitization.LimitationsAlthough d-AMPH induces manic-like behavior, the mechanisms underlying these effects can also be related to phenotypes of drug abuse.ConclusionsTogether, vulnerability to mania-like behavior following d-AMPH challenge and extensive neurotrophic alterations, suggest amphetamine-induced behavioral sensitization is a good model of BD pathophysiology.
  • Fear of cancer recurrence among breast cancer survivors could be
           controlled by prudent dietary modification with polyunsaturated fatty
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Ryo Okubo, Hiroko Noguchi, Kei Hamazaki, Masayuki Sekiguchi, Takayuki Kinoshita, Noriko Katsumata, Tomomi Narisawa, Yasuhito Uezono, Jinzhong Xiao, Yutaka J. Matsuoka BackgroundThe pathophysiology of fear of cancer recurrence (FCR), the leading unmet psychological need of cancer survivors, may involve the dysfunctional processing of fear memory. n-3 polyunsaturated fatty acids (PUFAs) have beneficial effects on psychiatric disorders, including depressive disorder and anxiety disorders, and are involved in fear memory processing. We hypothesized that n-3 PUFA composition is associated with FCR in cancer survivors.MethodsWe conducted a cross-sectional study to examine the relationship between n-3 PUFAs and FCR among breast cancer survivors. Adults who had been diagnosed with invasive breast cancer and were not undergoing chemotherapy were asked to participate. Blood PUFA composition was evaluated by using capillary blood. We directly administered the Concerns About Recurrence Scale (CARS) to assess the grade of FCR.ResultsAmong 126 participants used for the analysis, the mean age (SD) was 58 (11) years and 47% had stage I cancer. Multiple regression analysis controlling for possible confounders, depressive symptoms, and post-traumatic stress disorder (PTSD) symptoms revealed that the alpha-linolenic acid (ALA) level was significantly inversely associated with the average score on the CARS overall fear index (beta = −0.165, p = 0.04). No significant associations were found for other PUFAs.LimitationsOur findings were obtained from a cross-sectional study in a single institute.ConclusionThese findings provide the first evidence of a beneficial effect of ALA on FCR and indicate the need for prospective study of this association. FCR among breast cancer survivors might be controllable by prudent selection of ALA-containing cooking oil.
  • Prevalence of depressive disorder among patients with fibromyalgia:
           Systematic review and meta-analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): J.S. Løge-Hagen, A. Sæle, C. Juhl, P. Bech, E. Stenager, AI Mellentin BackgroundIt is acknowledged that fibromyalgia (FM) as a medical (rheumatological) disorder and major depressive disorder (MDD) as a mental disorder often co-occurs, but the inconsistency is prevailing at study-level and no overall estimate of the co-occurrence exist.AimsThis systematic review and meta-analysis aimed to estimate the overall point- and life-time prevalence of MDD among FM patients based on structured clinical interviews (SCI); and to estimate the point-prevalence of MDD among FM patients based on screening symptom scales (SSS).MethodThe electronical databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO were searched for papers that reported on prevalence of MDD among FM patients. Eligible studies were included in a random effects meta-analysis pooling the prevalence of depression.ResultsThe literature search identified 11 eligible studies for the meta-analysis. For SCI, the overall pooled point-prevalence (PP) was 25% (95% CI 19 to 31%), and life-time prevalence (LP) was 65% (95% CI 59 to 71%). When estimating the PP with self-administered SSS the overall pooled PP was 45% (95% CI 32 to 59%), and a single clinician–administered SSS yielded a PP of 23% (95% CI 10 to 41%). There was low inconsistency for the SCI and high inconsistency for the SSS.ConclusionOne fourth of all FM patients had MDD, and more than half experienced MDD during their life-time according to clinician-administered instruments. Prevalence of MDD was almost twice as high when using self-administered symptom scales and may be likely to overestimate the co-occurrence.
  • Gray and white matter differences in adolescents and young adults with
           prior suicide attempts across bipolar and major depressive disorders
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Siyan Fan, Elizabeth T.C. Lippard, Anjali Sankar, Amanda Wallace, Jennifer A.Y. Johnston, Fei Wang, Brian Pittman, Linda Spencer, Maria A. Oquendo, Hilary P. Blumberg BackgroundFindings regarding brain circuitry abnormalities in suicide attempters (SAs) converge across bipolar disorder (BD) and major depressive disorder (MDD), the most common disorders observed in suicides. These abnormalities appear to be present during adolescence/young adulthood when suicide rates increase steeply, and suicide is a leading cause of death in this age group. Identification of brain circuitry common to adolescent/young adult SAs with BD and MDD is important for generating widely effective early prevention strategies. We examined brain circuitry in SAs in adolescents/young adults across these two disorders.MethodsEighty-three participants (ages 14–25 years), 46 with BD (21 SAs) and 37 with MDD (19 SAs), underwent structural and diffusion-weighted magnetic resonance scanning. Whole-brain analyses compared gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) between SAs and non-suicide attempters (NSAs) across and within BD and MDD (p 
  • CRMP2 mediates GSK3β actions in the striatum on regulating neuronal
           structure and mania-like behavior
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Wonju Kim, Seong-Yeon Won, Bong-June Yoon BackgroundGenetic and physiological studies have implicated the striatum in bipolar disorder (BD). Although Glycogen synthase kinase 3 beta (GSK3β) has been suggested to play a role in the pathophysiology of BD since it is inhibited by lithium, it remains unknown how GSK3β activity might be involved. Therefore we examined the functional roles of GSK3β and one of its substrates, CRMP2, within the striatum.MethodsUsing CRISPR-Cas9 system, we specifically ablated GSK3β in the striatal neurons in vivo and in vitro. Sholl analysis was performed for the structural studies of medium spiny neurons (MSNs) and amphetamine-induced hyperlocomotion was measured to investigate the effects of gene ablations on the mania-like symptom of BD.ResultsGSK3β deficiency in cultured neurons and in neurons of adult mouse brain caused opposite patterns of neurite changes. Furthermore, specific knockout of GSK3β in the MSNs of the indirect pathway significantly suppressed amphetamine-induced hyperlocomotion. We demonstrated that these phenotypes of GSK3β ablation were mediated by CRMP2, a major substrate of GSK3β.LimitationsAmphetamine-induced hyperlocomotion only partially recapitulate the symptoms of BD. It requires further study to examine whether abnormality in GSK3β or CRMP2 is also involved in depression phase of BD. Additionally, we could not confirm whether the behavioral changes observed in GSK3β-ablated mice were indeed caused by the cellular structural changes observed in the striatal neurons.ConclusionOur results demonstrate that GSK3β and its substrate CRMP2 critically regulate the neurite structure of MSNs and their functions specifically within the indirect pathway of the basal ganglia network play a critical role in manifesting mania-like behavior of BD. Moreover, our data also suggest lithium may exert its effect on BD through a GSK3β-independent mechanism, in addition to the GSK3β inhibition-mediated mechanism.
  • The efficacy of adjunctive N-acetylcysteine in acute bipolar depression: A
           randomized placebo-controlled study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Pernille Kempel Ellegaard, Rasmus Wentzer Licht, René Ernst Nielsen, Olivia May Dean, Michael Berk, Henrik Enghusen Poulsen, Mohammadreza Mohebbi, Connie Thuroee Nielsen ObjectiveTo investigate the efficacy of adjunctive N-acetylcysteine (NAC) for the treatment of acute bipolar depression.MethodA randomized, double-blind, multicentre, placebo-controlled trial including adult subjects diagnosed with bipolar disorder, currently experiencing a depressive episode. Participants were treated with 3 g/day NAC or placebo as an adjunctive to standard treatment for 20 weeks, followed by a 4-week washout where the blinding was maintained. The primary outcome was the mean change in the Montgomery Asberg Depression Rating Scale (MADRS) score over the 20-week treatment phase. Linear Mixed Effects Repeated Measures (LMERM) was used for analysing the primary outcome.ResultsA total of 80 subjects were included. The mean MADRS score at baseline was 30.1 and 28.8 in participants randomized to NAC and placebo, respectively. Regarding the primary outcome measure, the between-group difference (NAC vs. placebo) was 0.5, which was statistically non-significant (95% CI: -7.0-5.9;p = 0.88). All findings regarding secondary outcomes were statistically or clinically insignificant.LimitationsThe study had a placebo response rate of 55.6% - high placebo response rates are associated with failure to separate from placebo.ConclusionsBased on our primary outcome measure, we could not confirm previous studies showing a therapeutic effect of adjunctive NAC treatment on acute bipolar depression. Further studies with larger samples are needed to elucidate if specific subgroups could benefit from adjunctive NAC treatment.
  • Anxiety and anhedonia in depression: Associations with neuroticism and
           cognitive control
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Allen Liao, Robrina Walker, Thomas J. Carmody, Crystal Cooper, Meredith A. Shaw, Bruce D. Grannemann, Phil Adams, Gerard E. Bruder, Melvin G. McInnis, Christian A. Webb, Daniel G. Dillon, Diego A. Pizzagalli, Mary L. Phillips, Benji T. Kurian, Maurizio Fava, Ramin V. Parsey, Patrick J. McGrath, Myrna M. Weissman, Madhukar H. Trivedi BackgroundDespite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia.MethodsUsing baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia.ResultsNeuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p 
  • Can't look Away: Attention control deficits predict Rumination, depression
           symptoms and depressive affect in daily Life
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Ilya Yaroslavsky, Eric S. Allard, Alvaro Sanchez-Lopez BackgroundRumination and a reduced capacity to disengage attention as appropriate to context (attention control deficits) have each been implicated in the etiology and maintenance of depressive disorders. However, it remains unclear whether rumination is a mechanism by which attention control deficits predict depression, and whether these relations are observed outside of laboratory settings. We tested whether rumination mediates the effects of attention control deficits marked by slow disengagement from negative-valenced stimuli (sad faces) and fast disengagement from positive-valenced stimuli (happy faces) on depression symptoms and depressive affects in the daily lives of adults with various depression histories.MethodForty-six participants (n = 23 with histories of Major Depressive Disorder) completed a clinical evaluation, an eye-tracking task that indexed attention control, and a 7-day Ecological Momentary Assessment (EMA) follow-up during which Negative (NA) and Positive Affect (PA) were measured at times of peak distress that occurred in the hour preceding each EMA prompt.ResultsDelayed disengagement from sad faces predicted elevated depression and NA levels, and low PA levels, independent of depression histories. Rumination mediated the effects of delayed disengagement from sad, and rapid disengagement from happy, faces on depression and NA levels. Effects of disengagement on rumination were maintained independent of depression levels.LimitationsOur sample size limited the detection of small statistical effects, and we could not clarify temporal relationships between attention control deficits and rumination.ConclusionOur findings suggest that attention inflexibility and rumination persist independent of depressive states and should be targets of clinical intervention.
  • Inflammation as a unique marker of suicide ideation distinct from
           depression syndrome among U.S. adults
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Rachel S. Bergmans, Kristen M. Kelly, Briana Mezuk BackgroundRecent evidence suggests that pro-inflammatory states may be independently associated with the risk of suicidality, above and beyond depression. This study assesses whether four indicators of inflammation, circulating levels of C-reactive protein (CRP), white blood cell (WBC) count and immunoglobulin E (IgE), and dietary inflammatory potential, measured using the Dietary Inflammatory Index® (DII), distinguish suicidal ideation (SI) from major depression (MD).MethodsData come from multiple cycles of the US National Health and Nutrition Examination Survey (NCRP&WBC = 13,912; NDII = 17,076; NIgE = 4,060). MD was measured using the Patient Health Questionnaire-9 (PHQ-9); SI was indicated by the last item of the PHQ-9. To assess SI independent from MD, participants were classified into four categories: SI with MD, SI without MD, MD without SI, and neither MD nor SI. Regression models were used to assess the relationship between indicators of inflammation and SI with and without MD.ResultsNone of the inflammatory indicators were able to distinguish SI status among MD cases. DII was associated with SI among individuals without MD. CRP, DII, and WBC were associated with MD. No associations were found for IgE.LimitationsCross-section data prevent drawing causal conclusions. Underreporting of MD and suicidal ideation and measurement of habitual diet using 24 h dietary recalls are also weaknesses.ConclusionDietary inflammatory potential was associated with suicide ideation among US adults with and without depression. Diet may play a role in suicide ideation and more empirical evidence is needed to determine whether nutritional protocols could aid in the treatment of suicidal behaviors. Findings did not support inflammatory factors having a relationship with suicide ideation distinct from depression.
  • Personality traits are related with dynamic functional connectivity in
           major depression disorder: A resting-state analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Xinran Wu, Hong He, Liang Shi, Yunman Xia, Kaixiang Zuang, Qiuyang Feng, Yao Zhang, Zhiting Ren, Dongtao Wei, Jiang Qiu BackgroundMajor depressive disorder (MDD) is one of the most well-known psychiatric disorders, which can be destructive for its damage to people's normal cognitive, emotional and social functions. Personality refers to the unique and stable character of thinking and behavior style of an individual, which has long been thought as a key influence factor for MDD. Although some knowledge about the common neural basic between MDD and personality traits has been acquired, there are few studies exploring dynamic neural mechanism behind them, which changes brain connectivity pattern rapidly to adapt to the environment over time.MethodsIn this study, the emerging dynamic functional network connectivity (DFNC) method was used in resting-state fMRI data to find the differences between healthy group (N = 107) and MDD group (N = 109) in state-based dynamic measures, and the correlations between these measures and personality traits (extraversion and neuroticism in Eysenck Personality Questionnaire, EPQ) were explored.ResultsThe results showed that MDD was significantly less than the health control group in dwell time and fraction time of state 4, which was positively correlated with extraversion score and negatively correlated with neuroticism score. Further exploration on state 4 showed that it had low modularity, hyper-connectedness of sensory-related regions and DMN, and weak connections between cortex and subcortical areas, which suggested that the absence of this state in MDD might represent a decrease in activity and positive emotions.ConclusionWe found the dynamic functional connectivity mechanism underlying MDD, confirmed our hypothesis that there existed the interacted relationship between trait, disease and the brain's dynamic characteristic, and suggested some reference for treatment of depression.
  • Prevalence of common mental disorders in widowhood: A systematic review
           and meta-analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Christina Blanner Kristiansen, Jesper Nørgaard Kjær, Peter Hjorth, Kjeld Andersen, A. Matthew Prina BackgroundWidowed people have a high risk of common mental disorders, however no summary estimates of the prevalences exist. The aim of this study was to conduct a systematic review and meta-analysis of the prevalence of common mental disorders in widowed people in the community.MethodsMEDLINE, Embase and PsycInfo were searched for papers reporting on prevalence of common mental disorders and widowhood. Eligible studies were included in random effects meta-analyses of the prevalence of depression and anxiety disorders. Subgroup analyses were performed on method of assessment of depression and age and sex.ResultsThe literature search identified 13,781 titles of which 42 were eligible for meta-analysis. The pooled prevalence of depression in studies using a screening scale was 40.6% (33.6%–47.6%) (n = 30). For studies using full diagnostic criteria the pooled prevalence of depression was 19.2% (13.4%–25.0%) (n = 12). Subgroup analyses of age (≥ or 
  • Nutraceuticals for major depressive disorder- more is not merrier: An
           8-week double-blind, randomised, controlled trial
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Jerome Sarris, Gerard J Byrne, Con Stough, Chad Bousman, David Mischoulon, Jenifer Murphy, Patricia Macdonald, Laura Adams, Sonia Nazareth, Georgina Oliver, Lachlan Cribb, Karen Savage, Ranjit Menon, Suneel Chamoli, Michael Berk, Chee Ng BackgroundOne of the most pressing questions in “Nutritional Psychiatry” is whether using combinations of different nutraceuticals with putative antidepressant activity may provide an enhanced synergistic antidepressant effect.MethodsA phase II/III, Australian multi-site, 8-week, double-blind, RCT involving 158 outpatients with a DSM-5 diagnosis of MDD. The intervention consisted of a nutraceutical combination: S-adenosyl methionine; Folinic acid; Omega-3 fatty acids; 5-HTP, Zinc picolinate, and relevant co-factors versus placebo. The primary outcome was change in MADRS score. Hypothesis-driven analyses of potential moderators of response involving key SNPs, and BDNF were also conducted.ResultsPlacebo was superior to the nutraceutical combination in reducing MADRS score (differential reduction -1.75 points), however a mixed linear model revealed a non-significant Group X Time interaction (p = 0.33). Response rates were 40% for the active intervention and 51% for the placebo; remission rates were 34% and 43% for active and placebo groups, respectively. No significant differences were found between groups on any other secondary depression, anxiety, psychosocial, or sleep outcome measures. Key SNPs and BDNF did not significantly moderate response. No significant differences occurred between groups for total adverse effects, aside from more nausea in the active group.LimitationsVery high placebo response rates suggest a placebo run-in design may have been valuable.InterpretationThe adoption of a nutraceutical ‘shotgun’ approach to treating MDD was not supported, and appeared to be less effective than adding placebo to treatment as usual.
  • Unmet health care needs in old age and their association with depression
           – results of a population-representative survey
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Janine Stein, Paula Liegert, Marie Dorow, Hans-Helmut König, Steffi G. Riedel-Heller Background: Due to the demographic changes, unmet health care needs are expected to increase in the elderly population. The aim of this study was to analyse the distribution of met and unmet needs and their association with depression in old age. Methods: Based on a population-representative telephone survey of the elderly population aged 75 + years and older, a sample of 845 individuals was assessed via structured clinical interviews. Data on unmet needs were collected via the adapted German version of the Camberwell Assessment of Need for the Elderly (CANE). Descriptive and interferential statistical analyses were run. Results: Most frequently, unmet needs were reported in the CANE sections memory, physical health and mobility. Significant differences with regard to age and gender were observed. Further, regression analyses revealed that unmet needs were significantly associated with depression. Limitations: Data on unmet needs were only assessed from the participants’ perspectives. The cross-sectional design of the study does not allow drawing conclusions on causality of results. Conclusion: This study provides, for the first time in Germany, population-representative data on unmet health care needs in the oldest old and represents an important starting point in the field of health and social care as well as the development of tailored treatment and interventions in old age.
  • Acute effects of aerobic exercise on negative affect and obsessions and
           compulsions in individuals with obsessive-compulsive disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Ana M. Abrantes, Samantha G. Farris, Richard A. Brown, Benjamin D. Greenberg, David R. Strong, Nicole C. McLaughlin, Deborah Riebe BackgroundThe acute effects of aerobic exercise on improved mood and anxiety reduction have been demonstrated across clinical and nonclinical populations. Limited work has evaluated the acute effects of aerobic exercise on negative affect, obsessions, and compulsions in patients with Obsessive Compulsive Disorder (OCD).MethodFifty-five patients (64% female) with treatment-resistant OCD were randomized to either 12 weeks of aerobic exercise (AE) or health education contact (HEC) control. Participants rated negative affect (i.e., mood and anxiety), obsessions and compulsions before and after each weekly AE or HEC session. Multilevel models were constructed to evaluate the effect of intervention condition, treatment week (time), and their interaction in terms of acute change in affect, obsession, and compulsions.ResultsResults reflected a main effect of condition, such that AE resulted in significantly larger increases in positive mood, and reductions in anxiety and compulsions, as compared to HEC. There was also a main effect of time in predicting acute anxiety reduction, such that linear reductions in anxiety over the course of treatment were observed. No significant effects were observed for acute changes in obsessions.LimitationsThe sample was small and was limited in demographic heterogeneity. Bouts of aerobic exercise were not standardized in terms of duration and mode, which could impact affective response to exercise, and acute affective OCD effects were exclusively self-reported.DiscussionThe current findings may help elucidate potential mechanisms of action of exercise on OCD outcomes. In addition, these results point toward the potential of designing exercise interventions that can teach patients to utilize individual bouts of physical activity, “in-the-moment” to improve mood and reduce anxiety and compulsions.
  • Exploration of the psychometric properties of the 33-item Hypomania
           Checklist - external assessment (HCL-33-EA)
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Meng Fang, Yuan-Yuan Wang, Yuan Feng, Gabor S. Ungvari, Chee H. Ng, Gang Wang, Yu-Tao Xiang, Jules Angst BackgroundMisdiagnosis of bipolar disorder (BD) is common in clinical practice, leading to inappropriate treatment and detrimental consequences. The 33-item Hypomania Checklist (HCL-33) is a newly developed screening instrument for hypomanic symptoms in patients with BD. The 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for carers of patients with mood disorders. In this study, the psychometric properties of the HCL-33-EA in a Chinese population were explored.MethodA total of 182 inpatients and 240 carers were recruited in this study. Patients were diagnosed with bipolar depression or major depressive disorder (MDD) according to the International Classification of Diseases (ICD-10). The patients completed the HCL-33, while their carers filled out the HCL-33-EA.ResultsThe HCL-33-EA showed high internal consistency (Cronbach's alpha = 0.876) with two-factorial dimensions. Paired samples t-test revealed that the mean score of the HCL-33-EA was significantly lower than that of the HCL-33 (t = 10.1, p 
  • Association of generalized anxiety symptoms and panic with health care
           costs in older age—Results from the ESTHER cohort study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): J.K. Hohls, B. Wild, D. Heider, H. Brenner, F. Böhlen, K.U. Saum, B. Schöttker, H. Matschinger, W.E. Haefeli, H.-H. König, A. Hajek BackgroundLittle is known specifically about the association between generalized anxiety symptoms or panic and health care costs in older age. The aim of this study was to examine the association between generalized anxiety symptoms, panic and health care costs in people aged 65 and over.MethodsCross-sectional data from the 8-year follow-up of a large, prospective cohort study, the ESTHER study, was used. Individuals aged 65 and over, who participated in the study's home assessment, were included in this analysis (n = 2348). Total and sectoral costs were analyzed as a function of either anxiety symptoms, probable panic disorder, or a panic attack, while controlling for selected covariates, using Two Part and Generalized Linear Models. Covariates were chosen based on Andersen's Behavioral Model of Health Care Use.ResultsThere was no significant association between either of the anxiety or panic measures and total health care costs. Stratified by health care sectors, only the occurrence of a panic attack was significantly associated with incurring costs for outpatient non-physician services (OR: 1.99; 95% CI: 1.15–3.45) and inpatient services (OR: 2.14; 95% CI: 1.07–4.28). Other illness-related factors, such as comorbidities and depressive symptoms, were associated with health care costs in several models.LimitationsThis was a cross-sectional study relying on self-reported data.ConclusionThis study points to an association between a panic attack and sector-specific health care costs in people aged 65 and over. Further research, especially using longitudinal data, is needed.
  • Altered white matter volumes in first-episode depression: Evidence from
           cross-sectional and longitudinal voxel-based analyses
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): M. Carceller-Sindreu, M. Serra-Blasco, J. de Diego-Adeliño, Y. Vives-Gilabert, M. Vicent-Gil, E. Via, D. Puigdemont, E. Álvarez, V. Pérez, M.J. Portella BackgroundMajor depressive disorder (MDD) is accompanied by atypical brain structure affecting grey and white matter from the early stages. Neuroimaging studies of first-episode depression (FED) have provided evidence on this regard, but most of the studies are cross-sectional. The aim of this longitudinal study was to test potential changes in grey matter (GM) and white matter (WM) volumes in FED.MethodsThirty-three untreated FED patients (DSM-IV criteria) and 33 healthy controls (HC) underwent a 3T structural magnetic resonance imaging (sMRI) at baseline and after 2 years. Depressive symptoms were assessed at baseline and throughout the study with the 17-item Hamilton Depressive Rating Scale (HDRS-17). Recurrences of FED patients were also collected along the follow-up. To analyze GM and WM differences, whole-brain voxel-based morphometry (VBM, SPM12) was employed (FWE corrected).ResultsFED patients showed significant reductions compared to HC in WM volumes of prefrontal cortex (left anterior corona radiata). No differences were found in GM volumes. Full factorial longitudinal analysis of the whole sample revealed no significant effect in GM nor in WM, while the full factorial longitudinal analysis comparing recurrent and non-recurrent patients showed increments in WM volumes of left posterior corona radiata and right posterior thalamic radiation in the recurrent group.LimitationsLimited sample size, especially in the follow-up.ConclusionsThe present findings provided some new evidence of the role of white matter alterations in the early stages of MDD and in the progression of the illness.
  • Course of a major postpartum depressive episode: A prospective 2 years
           naturalistic follow-up study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Anna Torres, Estel Gelabert, Alba Roca, Purificación Navarro, Anna Plaza, Susana Subirà, Rocío Martin-Santos, Carlos Ascaso, Lluïsa Garcia-Esteve BackgroundSurvival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course.MethodThis was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE).ResultsOf the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0–59.8). The probability of recovering was 30.2% (95% CI: 22.1%–37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%–73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%–95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission.LimitationsResults are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed.ConclusionsOur findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.
  • Double-blind, placebo-controlled trial of pioglitazone for bipolar
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Awais Aftab, David E. Kemp, Stephen J. Ganocy, Martha Schinagle, Carla Conroy, Brittany Brownrigg, Nicole D'Arcangelo, Toyomi Goto, Nicole Woods, Mary Beth Serrano, Huiqin Han, Joseph R. Calabrese, Keming Gao BackgroundObjective of the present study was to conduct an 8-week double-blind, randomized, placebo-controlled trial to test the efficacy of pioglitazone in the treatment of bipolar depression.Methods38 outpatients with bipolar disorder and current major depressive episode were randomized to pioglitazone (15–45 mg/day) or placebo. The use of concomitant mood stabilizers, antipsychotics, and antidepressants was permitted. The primary outcome measure was the 30-item Inventory of Depressive Symptomatology, Clinician Rated (IDS-C30) total score change from baseline to endpoint. Laboratory evaluations, including serum level of inflammatory and metabolic biomarkers, were conducted.Results37 subjects were analyzed for efficacy (1 subject had no follow-up data). Mean reduction from baseline to week 8 in IDS-C30 score was−6.59 for pioglitazone and −11.63 for placebo. Mixed effects modeling indicated borderline statistically significant difference between the two groups (p = 0.056) in favor of placebo. On analysis of inflammatory and metabolic markers, a statistically significant negative correlation was noted between change in leptin levels and change in depression scores in the pioglitazone group (r = −0.61, p = 0.047) but not in the placebo group, the significance of which is unclear as the study failed to demonstrate antidepressant efficacy of pioglitazone over placebo. No serious adverse effects were reported, and pioglitazone was well-tolerated.Limitationssmall sample size with inadequate power, concomitant use of other psychotropic medications, and lack of statistical adjustment for multiple testing.ConclusionCurrent study does not support the antidepressant efficacy of pioglitazone in the treatment of bipolar depression. (240 words)
  • Psychological distress in cancer patients in a large Chinese
           cross-sectional study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Wen-Wang Rao, Ming-Jia Yang, Bo-Nan Cao, Yue-Yue You, Yang-Yu Zhang, Ying-Yu Liu, Changgui Kou, Yaqin Yu, Ryan M. Cassidy, Qiong Yu, Xiang Yang Zhang BackgroundAlthough psychological distress is common among patients with chronic diseases, the degree of risk for developing psychological distress is not well-established. Our aim with this study is to determine the odds ratio for psychological distress in patients with cancer as compared to either 1) patients with chronic disease patients without cancer, or 2) healthy controls in a large representative sample of Chinese population.MethodsUsing a multistage, stratified cluster sampling method, 21,101 subjects 18–79 years old were interviewed face-to-face in Jilin province, China. Their psychological status was assessed with the 12-item General Health Questionnaire (GHQ-12). A total score of ≥4 was used as the threshold for determining psychological distress.ResultsThe prevalence of psychological distress was 14.08% across the entire sample: 10.63% in healthy controls; 14.81% in patients with chronic diseases; and 20% in patients with cancer. Multiple logistic regression analysis indicated that, as compared to the health controls, both cancer (OR = 1.609, 95%CI = 1.245–2.081) and chronic disease patients (OR = 1.330, 95%CI = 1.189–1.478) were more likely to suffer from psychological distress. Moreover, cancer patients had a higher risk of psychological distress than patients with chronic diseases (OR = 1.295, 95%CI = 1.049–1.600; p = 0.016). In addition, the cancer group (2.68 ± 0.114) demonstrated a higher GHQ score than the patients with chronic diseases (2.30 ± 0.017) and healthy controls (1.98 ± 0.029) (both p 
  • Simvastatin prevents and ameliorates depressive behaviors via
           neuroinflammatory regulation in mice
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Xu-Ben Yu, Hai-Na Zhang, Ying Dai, Zi-Ye Zhou, Ren-ai Xu, Lu-Feng Hu, Chun-Hong Zhang, Hui-Qin Xu, Yun-Qi An, Cong-Rong Tang, Guan-Yang Lin BackgroundStatins play a beneficial role in the treatment of coronary artery disease and are widely prescribed to prevent hypercholesterolemia. Previous studies have demonstrated that statins also have anti-inflammatory and immunomodulatory properties, and these are being explored for potential benefits in depression. However, the role of statins in the treatment of depression has not been well examined.MethodsWe investigated the effects of simvastatin on depressive behaviors and neuroinflammation in lipopolysaccharide (LPS) and chronic mild stress (CMS) induced depression model in mice. Sucrose preference test (SPT), forced swimming test (FST), novelty-suppressed feeding test (NSFT) were used to detect the depressive behaviors. The microglial activation was detected by immunohistochemistry analysis and the pro-inflammatory cytokines expressions including IL-1β, TNF-α and IL-6 were examined by Western blot analysis.ResultsOur data indicated that oral administration of simvastatin at 20 mg/kg significantly prevented and ameliorated depressive behaviors reflected by better performance in the SPT, FST and NSFT. Moreover, simvastatin markedly prevented and ameliorated LPS and CMS-induced neuroinflammation, as shown by the suppressed activation of microglia in hippocampus and decreased hippocampal pro-inflammatory cytokines expressions including IL-1β, TNF-α, IL-6, which might be mediated via the inhibition of NF-κB pathway, as shown by the decreased nuclear NF-κB p65 expression.LimitationsThe interpretation of the evidence of a positive treatment effect of simvastatin on the depressive manifestations, multifaceted etiology of depression, and confirmation of this finding from animal models to humans is needed.ConclusionThese results suggest that simvastatin has the potential to be employed as a therapy for depression associated with neuroinflammation.
  • The association between child and adolescent depression and poor
           attendance at school: A systematic review and meta-analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Katie Finning, Obioha C Ukoumunne, Tamsin Ford, Emilia Danielsson-Waters, Liz Shaw, Ingrid Romero De Jager, Lauren Stentiford, Darren A Moore BackgroundDepression in young people may lead to reduced school attendance through social withdrawal, loss of motivation, sleep disturbance and low energy. We systematically reviewed the evidence for an association between depression and poor school attendance.MethodsSeven electronic databases were searched for quantitative studies with school-aged children and/or adolescents, reporting a measure of association between depression and school attendance. Articles were independently screened by two reviewers. Synthesis incorporated random-effects meta-analysis and narrative synthesis.ResultsSearches identified 4930 articles. Nineteen studies from eight countries across North America, Europe, and Asia, were included. School attendance was grouped into: 1) absenteeism (i.e. total absences), 2) excused/medical absences, 3) unexcused absences/truancy, and 4) school refusal. Meta-analyses demonstrated small-to-moderate positive cross-sectional associations between depression and absenteeism (correlation coefficient r = 0.11, 95% confidence interval 0.07 to 0.15, p = 0.005, I2 = 63%); and depression and unexcused absences/truancy (r = 0.15, 95% confidence interval 0.13 to 0.17, p 
  • Association of secondhand smoke and depressive symptoms in nonsmoking
           pregnant Women: A systematic review and meta-analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Daichi Suzuki, Windy M.V. Wariki, Maiko Suto, Noyuri Yamaji, Yo Takemoto, Md. Mosfequr Rahman, Erika Ota Background: Globally about 30% of adult women and 40% of children are exposed to secondhand smoke (SHS) from active smokers. SHS exposure of pregnant women has been associated with postpartum depression. Unexposed women in pregnancy had lower rates of postpartum depression than women exposed to SHS. This systematic review aimed to determine the association of depressive symptoms and exposure to SHS in nonsmoking pregnant women.Method: The case-controlled, cross-sectional, and cohort studies with a comparison group were included. Studies including women who had smoking history during pregnancy were excluded. The comprehensive electronic databases, CINAHL, EMBASE, and Medline were searched.Result: Of the 2777 records screened, seven studies were included in the review for data extraction. The bias of studies was assessed using the RoBANS. We synthesized two studies that showed depressive symptoms at any time during pregnancy and postpartum significantly increased (ORs = 1.77 [95% CI = 1.12 – 2.79]; p = 0.01; I2 = 28%, 4103 women, two studies), and significantly increased the odds of antenatal suicidal ideation in SHS exposed women (ORs = 1.75 [95% CI = 1.14 – 2.70]; p = 0.01; I2 = 51%, 2670 women, two studies). Lack of studies from counties with the highest smoking rates was a limitation.Conclusions: SHS exposure during pregnancy showed a significant increase in the odds of depressive symptoms. Furthermore, research is required to clarify to association between SHS and depression.
  • Decline in sexuality and wellbeing in older adults: A population-based
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Sarah E. Jackson, Joseph Firth, Nicola Veronese, Brendon Stubbs, Ai Koyanagi, Lin Yang, Lee Smith BackgroundAge-related declines in sexuality and increase in mental health complications have been well documented. However, whether these two phenomena are related has not been explored. The present study therefore aimed to investigate associations between a decline in sexuality and markers of mental health and wellbeing.MethodData were collected in 2012/13 from 2614 men and 3217 women participating in the English Longitudinal Study of Ageing, a population-representative panel study of older adults (≥ 50 years). Past-year declines in sexual desire, frequency of sexual activities, and sexual function were self-reported. Three markers of wellbeing (depressive symptoms, quality of life and life satisfaction) were assessed using validated scales. Associations between declines in sexuality and wellbeing were analysed using one-way independent analyses of variance, adjusted for a range of socio-demographic and health-related covariates.ResultsMen and women who reported a past-year decline in sexual desire or frequency of sexual activities had a higher number of depressive symptoms (desire p = 0.001, frequency p 
  • Prospective associations of androgens and sex hormone-binding globulin
           with 12-month, lifetime and incident anxiety and depressive disorders in
           men and women from the general population
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Eva Asselmann, Hanna Kische, Robin Haring, Johannes Hertel, Carsten-Oliver Schmidt, Matthias Nauck, Katja Beesdo-Baum, Hans-Jörgen Grabe, Christiane Pané-Farré BackgroundFindings on associations of androgens and sex hormone-binding globulin (SHBG) with anxiety and depressive disorders in the general population remain inconclusive.MethodsWe used data of n = 993 men and n = 980 women from the Study of Health in Pomerania (SHIP, a prospective-longitudinal general population study from northeastern Germany). Immunoassay-measured serum concentrations of total testosterone, androstenedione and SHBG were assessed when participants were aged 20–80. 12-month, lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up, when participants were aged 29–89. Logistic regressions were adjusted for age, smoking, alcohol consumption, physical activity, waist circumference, hypertension and oral contraceptive use (women only) at baseline and follow-up interval.ResultsIn men and women, androgens and SHBG were not associated significantly with incident anxiety and depressive disorders. In men, higher total testosterone predicted any 12-month (OR = 1.46) and lifetime (OR = 1.34) anxiety disorder, lifetime social phobia (OR = 2.15), and 12-month (OR = 1.48) and lifetime (OR = 1.39) specific phobia, but neither 12-month nor lifetime depression. Moreover, androstenedione in men interacted with age in predicting lifetime anxiety disorders (OR = 0.98): Higher androstenedione more strongly predicted lifetime anxiety in younger vs. older men. These findings, however, did not survive correction for multiple testing. In women, androgens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders.LimitationsThe follow-up period was relatively long and other factors might have affected the examined associations.ConclusionsHigher serum total testosterone in men and androstenedione in younger men may relate to an increased risk of anxiety disorders.
  • Depression symptomatology correlates with event-related potentials in
           Parkinson's disease: An affective priming study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Nadeeka N.W. Dissanayaka, Tiffany R. Au, Anthony J. Angwin, Kartik K. Iyer, John D. O'Sullivan, Gerard J. Byrne, Peter A. Silburn, Rodney Marsh, George D. Mellick, David A. Copland BackgroundDepression is a predominant non-motor symptom of Parkinson's disease (PD), which is often under recognised and undertreated. To improve identification of depression in PD it is imperative to examine objective brain-related markers. The present study addresses this gap by using electroencephalography (EEG) to evaluate the processing of emotionally valanced words in PD.MethodsFifty non-demented PD patients, unmedicated for depression or anxiety, completed an affective priming task while EEG was simultaneously recorded. Prime and target word pairs of negative or neutral valence were presented at a short 250 ms stimulus onset asynchrony. Participants were asked to evaluate the valence of the target word by button press. Depression was measured using an established rating scale. Repeated measures analysis of covariance and correlational analyses were performed to examine whether event-related potentials (ERP) varied as a function of depression scores.ResultsKey ERP findings reveal reduced responses in parietal midline P300, N400 and Late Positive Potential (LPP) difference waves between congruent and incongruent neutral targets in patients with higher depression scores.LimitationsComparisons of ERPs were limited by insufficient classification of participants with and without clinical depression. A majority of PD patients who had high depression scores were excluded from the analysis as they were receiving antidepressant and/or anxiolytic medications which could interfere with ERP sensitivity.ConclusionsThe present study suggests that the Pz-P300, N400 and LPP are ERP markers relates to emotional dysfunction in PD. These findings thus advance current knowledge regarding the neurophysiological markers of a common neuropsychiatric deficit in PD.
  • Concordance of genetic variation that increases risk for anxiety disorders
           and posttraumatic stress disorders and that influences their underlying
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Celia van der Merwe, Neda Jahanshad, Josh W. Cheung, Mary Mufford, Nynke A. Groenewold, Nastassja Koen, Rajkumar Ramesar, Shareefa Dalvie, ENIGMA Consortium PGC-PTSD, James A. Knowles, Derrek P. Hibar, Caroline M. Nievergelt, Karestan C. Koenen, Israel Liberzon, Kerry J. Ressler, Sarah E. Medland, Rajendra A. Morey, Paul M. Thompson, Dan J. Stein BackgroundThere have been considerable recent advances in understanding the genetic architecture of anxiety disorders and posttraumatic stress disorder (PTSD), as well as the underlying neurocircuitry of these disorders. However, there is little work on the concordance of genetic variations that increase risk for these conditions, and that influence subcortical brain structures. We undertook a genome-wide investigation of the overlap between the genetic influences from single nucleotide polymorphisms (SNPs) on volumes of subcortical brain structures and genetic risk for anxiety disorders and PTSD.MethodWe obtained summary statistics of genome-wide association studies (GWAS) of anxiety disorders (Ncases = 7016, Ncontrols = 14,745), PTSD (European sample; Ncases = 2424, Ncontrols = 7113) and of subcortical brain structures (N = 13,171). SNP Effect Concordance Analysis (SECA) and Linkage Disequilibrium (LD) Score Regression were used to examine genetic pleiotropy, concordance, and genome-wide correlations respectively. SECAs conditional false discovery was used to identify specific risk variants associated with anxiety disorders or PTSD when conditioning on brain related traits.ResultsFor anxiety disorders, we found evidence of significant concordance between increased anxiety risk variants and variants associated with smaller amygdala volume. Further, by conditioning on brain volume GWAS, we identified novel variants that associate with smaller brain volumes and increase risk for disorders: rs56242606 was found to increase risk for anxiety disorders, while two variants (rs6470292 and rs683250) increase risk for PTSD, when conditioning on the GWAS of putamen volume.LimitationsDespite using the largest available GWAS summary statistics, the analyses were limited by sample size.ConclusionsThese preliminary data indicate that there is genome wide concordance between genetic risk factors for anxiety disorders and those for smaller amygdala volume, which is consistent with research that supports the involvement of the amygdala in anxiety disorders. It is notable that a genetic variant that contributes to both reduced putamen volume and PTSD plays a key role in the glutamatergic system. Further work with GWAS summary statistics from larger samples, and a more extensive look at the genetics underlying brain circuits, is needed to fully delineate the genetic architecture of these disorders and their underlying neurocircuitry.
  • The use of machine learning in the study of suicidal and non-suicidal
           self-injurious thoughts and behaviors: A systematic review
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Taylor A. Burke, Brooke A. Ammerman, Ross Jacobucci BackgroundMachine learning techniques offer promise to improve suicide risk prediction. In the current systematic review, we aimed to review the existing literature on the application of machine learning techniques to predict self-injurious thoughts and behaviors (SITBs).MethodWe systematically searched PsycINFO, PsycARTICLES, ERIC, CINAHL, and MEDLINE for articles published through February 2018.ResultsThirty-five articles met criteria to be included in the review. Included articles were reviewed by outcome: suicide death, suicide attempt, suicide plan, suicidal ideation, suicide risk, and non-suicidal self-injury. We observed three general aims in the use of SITB-focused machine learning analyses: (1) improving prediction accuracy, (2) identifying important model indicators (i.e., variable selection) and indicator interactions, and (3) modeling underlying subgroups. For studies with the aim of boosting predictive accuracy, we observed greater prediction accuracy of SITBs than in previous studies using traditional statistical methods. Studies using machine learning for variable selection purposes have both replicated findings of well-known SITB risk factors and identified novel variables that may augment model performance. Finally, some of these studies have allowed for subgroup identification, which in turn has helped to inform clinical cutoffs.LimitationsLimitations of the current review include relatively low paper sample size, inconsistent reporting procedures resulting in an inability to compare model accuracy across studies, and lack of model validation on external samples.ConclusionsWe concluded that leveraging machine learning techniques to further predictive accuracy and identify novel indicators will aid in the prediction and prevention of suicide.
  • Intrinsic brain abnormalities in drug-naive patients with
           obsessive-compulsive disorder: A resting-state functional MRI study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Xi Yang, Xinyu Hu, Wanjie Tang, Bin Li, Yanchun Yang, Qiyong Gong, Xiaoqi Huang BackgroundUsing the resting-state functional magnetic resonance imaging (rs-fMRI) in a relatively large sample of drug-naive patients with obsessive-compulsive disorder (OCD), the current study aims to explore alterations in regional and network-level neural function and to determine the association between these alterations in intrinsic neural activity and symptom severity in OCD.MethodsA total of 68 drug-naive OCD patients and 68 healthy control subjects (HCS) were examined using rs-fMRI. Regional cerebral function was evaluated by measuring the fraction of amplitude of low-frequency fluctuation (fALFF). Regions with fALFF alterations were used as seeds in whole-brain functional connectivity (FC) analysis. Statistical analyses of fALFF and FC differences between OCD patients with HCS were performed voxel-by-voxel using a two-sample t-test in Statistical Parametric Mapping version 8 (SPM8). Whole brain correlation analyses were performed to identify the association between functional neural correlates and OCD symptom severity evaluated using Yale-Brown Obsessive Compulsive scale (Y-BOCS) and subscale scores.ResultsRelative to HCS, OCD patients showed higher fALFF in the right putamen and right superior frontal gyrus (P 
  • Differentiating bipolar disorder from borderline personality disorder:
           Diagnostic accuracy of the difficulty in emotion regulation scale and
           personality inventory for DSM-5
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): J Christopher Fowler, Alok Madan, Jon G Allen, John M Oldham, B Christopher Frueh BackgroundConfusion abounds when differentiating the diagnoses of bipolar disorder (BD) from borderline personality disorder (BPD). This study explored the relative clinical utility of affective instability and self-report personality trait measures for accurate identification of BD and BPD.MethodsReceiver operator characteristics and diagnostic efficiency statistics were calculated to ascertain the relative diagnostic efficiency of self-report measures. Inpatients with research-confirmed diagnoses of BD (n = 341) or BPD (n = 381) completed the Difficulty in Emotion Regulation Scale (DERS) and Personality Inventory for DSM-5 (PID-5).ResultsThe total score for DERS evidenced relatively poor accuracy for differentiating the disorders (AUC = 0.72, SE = 0.02, p 
  • Celebrity suicide on Twitter: Activity, content and network analysis
           related to the death of Swedish DJ Tim Bergling alias Avicii
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Thomas Niederkrotenthaler, Benedikt Till, David Garcia BackgroundMedia recommendations for suicide reporting are recommended to prevent imitative suicide but little is known about social media reactions to different revelations about celebrity suicide.MethodsUsing the Twitter Application Programming Interface (API), we recorded public tweets mentioning Avicii from the day when his death was reported (N = 2,865,292). We compared that data with a dataset of random tweets. Furthermore, we recorded tweets including suicide in 124 languages before Avicii‘s death (N = 5,939,107). We processed English tweets mentioning Avicii with the Linguistic Inquiry and Word Count (LIWC) to quantify the frequency of affects and related linguistic signals. We also processed the text of tweets to detect tweets mentioning the suicide method, and we retrieved the list of followers of users who tweeted about the method. We constructed reply networks from the dataset, analysing three networks corresponding to the major news events about Avicii‘s death.ResultsAvicii's suicide sparked immediate strong interest with both positive (χ² = 781.06, p 
  • Directionality of change in obsessive compulsive disorder (OCD) and
           suicidal ideation over six years in a naturalistic clinical sample✰
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Lily A. Brown, Emily Wakschal, Stefanie Russman-Block, Christina L. Boisseau, Maria C. Mancebo, Jane L. Eisen, Steven A. Rasmussen BackgroundObsessive compulsive disorder (OCD) is associated with elevated suicide risk, but the directionality of the association between OCD severity and suicidal ideation has not been established, which was the goal of this study.MethodsParticipants (n = 325) were adults with either a current or past diagnosis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) OCD who were assessed annually for suicidal ideation and OCD symptom severity for six years. Cross-lagged panel analyses statistically compared unidirectional and bidirectional models over time. Serious suicide-related adverse events were reported.ResultsThe best-fitting and most parsimonious model included paths predicting suicidal ideation from OCD symptom severity, but not vice versa. These results were confirmed by comparing a model with cross-lagged paths constrained equal to a freely estimated model. Higher OCD symptom severity in a given year was associated with a higher suicidal ideation severity in the subsequent year. Five suicide-related adverse events were reported throughout the duration of the study, including two suicide deaths and three suicide attempts.LimitationsThe study relied on a single-item, annual measure of suicidal ideation in adults, with substantial variability in severity of suicide risk, and missing data increased with later observations in the study.DiscussionOCD symptom severity predicted next year suicidal ideation severity. In contrast, suicidal ideation severity in a given year did not predict next-year OCD symptom severity in this OCD sample. Thus, rather than waiting for suicidal ideation to resolve, clinicians should consider providing empirically supported treatments for OCD.
  • Major depressive disorder in Mexican medical students and associated
           factors: A focus on current and past abuse experiences
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Francisco Romo-Nava, Rosa I. Bobadilla-Espinosa, Silvia A. Tafoya, Diana P. Guízar-Sánchez, Joaquín R. Gutiérrez, Pilar Carriedo, Gerhard Heinze BackgroundMajor depressive disorder (MDD) is highly prevalent among medical students (MS). Abuse experiences, as well as stress, are among the factors associated with MDD. However, their association with MDD in MS has been scarcely addressed.MethodsA cross-sectional study design was used to evaluate the association between MDD and possible risk factors, focusing on current and past abuse experiences inside and outside the academic setting in a large representative MS sample (n = 1,068) using self-report instruments to assess MDD (PHQ-9) and perceived academic stress levels during exam season.ResultsDepressive symptom severity directly correlates with levels of perceived academic stress. The prevalence of MDD was 16.2%. A history of emotional abuse during childhood or adolescence, as well as most types of current abuse were associated with MDD. Multiple logistic regression analysis showed that current emotional abuse outside school had the strongest association with MDD in MS, followed by a personal history of depression and suicide attempt, a family history of depression, and perceived academic stress levels.LimitationsCross-sectional design, participants represent a specific population, and other variables that could be associated with MDD: comorbid psychiatric disorders, current antidepressant treatment and protective factors (resilience and health-promoting coping strategies) were not evaluated.ConclusionsMDD is strongly associated with several risk factors that include most types of current and past abuse experiences. Timely identification of individuals at-risk will be critical to establish preventive strategies to limit the impact of MDD in MS and offer prompt therapeutic alternatives when needed.
  • Empirically-derived response trajectories of intensive residential
           treatment in obsessive-compulsive disorder: A growth mixture modeling
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Martha J. Falkenstein, Jacob A. Nota, Jason W. Krompinger, Meghan Schreck, Lauryn E. Garner, Sriramya Potluri, Nathaniel Van Kirk, Gabriella Ponzini, Eric Tifft, Brian P. Brennan, Brittany Mathes, Jordan Cattie, Jesse M. Crosby, Jason A. Elias BackgroundThis study investigated distinct trajectories of treatment response in a naturalistic intensive/residential treatment (IRT) program for adults with severe obsessive-compulsive disorder (OCD). We hypothesized that: (1) distinct trajectories would emerge and (2) demographic variables, psychiatric comorbidity, OCD symptom subtype, level of insight, previous exposure and response prevention (ERP) treatment, and quality of life, would differentially predict assignment to these trajectories.MethodsParticipants included 305 individuals with primary OCD admitted for IRT.ResultsTwo trajectories emerged over the course of the first eight weeks of treatment, with the vast majority of participants demonstrating treatment response. The first trajectory (96%, n = 292) showed a negative, linear treatment response (a.k.a. “linear responders”) and more severe OCD symptoms at admission. The second trajectory (4%, n = 13) had less severe OCD symptoms at admission and did not exhibit a significant overall change in symptoms over the course of treatment. More specifically, this second trajectory or “u-shaped responders” show a non-significant linear response through week four of treatment, followed by slightly increased symptoms in week five. Assignment to these classes was not differentially predicted by hypothesized predictor variables.LimitationsOur final model had inconsistent fit indices and small class prevalance of the u-shaped responder group; therefore, model selection was based on both fit indices and substantive meaning.ConclusionsThis study emprically derived two distinct trajectories of OCD symptom severity over the course of IRT. These findings have the potential to refine IRT for patients with severe OCD, and to potentially guide future investigation into the optimal delivery of ERP treatment for OCD generally.
  • Is there a relationship between depression with anxious distress DSM-5
           specifier and bipolarity' A multicenter cohort study on patients with
           unipolar, bipolar I and II disorders
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Antonio Tundo, Laura Musetti, Rocco de Filippis, Claudia Del Grande, Valentina Falaschi, Luca Proietti, Liliana Dell'Osso BackgroundTo estimate the prevalence of DSM-5 anxious distress specifier (ADS) in depressed patients with major depressive disorder (MDD) or bipolar I or II disorder (BD), and to compare socio-demographic and clinical characteristics, and response to naturalistic short-term treatment between ADS and non-ADS group.Methods241 outpatients with a major depressive episode (MDE) were consecutively recruited. Outcome were remission (HDRS21 total score 
  • Divalproex and its effect on suicide risk in bipolar disorder: A
           systematic review and meta-analysis of multinational observational studies
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Tien-Yu Chen, Masoud Kamali, Che-Sheng Chu, Chin-Bin Yeh, San-Yuan Huang, Wei-Chung Mao, Pao-Yen Lin, Yen-Wen Chen, Ping-Tao Tseng, Chung-Yao Hsu BackgroundDivalproex has become the most prevalent mood stabilizer for bipolar disorder. However, little is known its effects in the prevention of suicide in patients with bipolar disorder, and recent FDA announcement indicated an increased risk of suicidality when using anti-epileptic agents such as divalproex. The aim of this study is to investigate the effect of divalproex on suicide risk in patients with bipolar disorder.MethodsA search strategy was used for the PubMed, Embase, ProQuest, ScienceDirect, Cochrane Library, ClinicalKey, Web of Science, and until June 13th, 2018. Peer-reviewed observationally clinical studies in humans, investigating the association of divalproex and suicidality in patients with bipolar disorder were included. A random-effects meta-analysis was implemented to calculate the relative risk (RR) and 95% confidence intervals (CIs) for suicidality among patients receiving divalproex and those without.ResultsTotal 6 studies were included in the final meta-analysis. There was no significant difference in the incidence rates (reported as [RR]; 95% CI) of suicide attempts (0.921; 0.383–2.215) or completed suicides (0.607; 0.180–2.043) between participants receiving divalproex vs. no medication. There was no significant difference in the incidence rates of suicide attempts (0.815; 0.453–1.466) or completed suicides (1.009; 0.410–2.484) between participants receiving divalproex and carbamazepine.LimitationsThe significantly heterogeneous sample sources and study design amount the included trials.ConclusionsTreatment with divalproex did not reduce or increase the incidence of suicide-related events in patients with bipolar disorder.
  • Negative peer social interactions and oxytocin levels linked to suicidal
           ideation in anxious youth
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Eli R. Lebowitz, Hilary P. Blumberg, Wendy K. Silverman BackgroundAnxious youth are at risk for negative peer interactions including peer victimization, and for suicidal ideation. However, data about the pattern of association between these two factors are scarce. In this study we examined the association between negative peer interactions and suicidal ideation in a sample of children and adolescents with anxiety disorders, and whether oxytocin, which has been shown to enhance the impact of social events, moderates the impact of negative peer interactions on suicidal ideation.MethodParticipants were 168 youths with primary anxiety disorders. All participants were assessed with semi-structured diagnostic interviews, and with self-report measures of suicidal ideation, negative peer interactions, anxiety, and depression. The anxious youths’ salivary oxytocin levels were measured with immunoassay.ResultsThirty percent of the anxious youths reported suicidal ideation, with suicidal ideation severity associated with negative peer social interactions and depressive symptoms. Consistent with past data indicating that oxytocin enhances the impact of social events, the association between peer negative social interactions and suicidal ideation was stronger in youths with high oxytocin levels than in youths with low levels (i.e., moderation).LimitationsAssessment focused on suicidal ideation and data on suicidal behavior were not available. Limitations inherent to immunoassay measurement of peripheral oxytocin levels are noted.ConclusionNegative peer interactions are associated with suicidal ideation in youth with anxiety disorders, and the association is stronger in youth with high oxytocin levels.
  • What bridges the gap between emotional intelligence and suicide risk in
           victims of bullying' A moderated mediation study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Cirenia Quintana-Orts, Lourdes Rey, Sergio Mérida-López, Natalio Extremera BackgroundRecent research has demonstrated that victims of bullying report serious problems, such as depression, which heighten the risk of suicide. Emotional intelligence (EI) has been increasingly recognized as a protective factor, but little is known about the mechanisms underlying the relation between EI and suicide risk in victims. This study aimed to test a theoretical model of how EI, depressive symptoms and gender interact to influence suicidal ideation and attempts in a sample of Spanish victims of bullying.MethodsThe sample comprised 465 victims (273 girls) who completed self-report measures of perceived EI, depression and suicide risk.ResultsMediation and moderation analyses were performed using conditional process analysis. Findings showed that EI is a predictor of decreased suicide in victims. This relationship was partially mediated by depressive symptoms. Furthermore, this effect was moderated by gender, such that the mediation effect was stronger in girls compared to boys (moderated mediation).LimitationsThe cross-sectional design and the use of self-report instruments. Future research should address the longitudinal relations of these findings.ConclusionsThe promotion of emotional skills could be core to the development of suicide prevention programs in those high-risk adolescents who have suffered from bullying. Furthermore, gender should be taken into consideration, especially with regard to females reporting depressive symptoms related to having been bullied.
  • The role of childhood abuse for suicidality in the context of the
           interpersonal theory of suicide: An investigation in German psychiatric
           inpatients with depression
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): A. Schönfelder, N. Hallensleben, L. Spangenberg, T. Forkmann, D. Rath, H. Glaesmer BackgroundSeveral studies provide evidence for a relationship between childhood abuse and suicidality across the lifespan. To examine this association in the context of the Interpersonal Psychological Theory of Suicide (IPTS), we investigated whether its constructs thwarted belongingness, perceived burdensomeness and capability for suicide are potential mediators.MethodsEighty-four German psychiatric inpatients with unipolar depression (M = 37.6 years, 69% female) and current or lifetime suicidal ideation were included. For the assessment we used the Childhood Trauma Screener (CTS), the Rasch-based Screening for Depression (DESC-I), the Interpersonal Needs Questionnaire (INQ), the German Capability for Suicide Questionnaire (GCSQ), the Beck Scale for Suicide Ideation (BSS) and the Suicide Behaviors Questionnaire-Revised (SBQ-R). Simple and multiple mediator analyses were applied.ResultsMost patients (70%) had experienced childhood abuse. Emotional abuse showed an indirect association with suicidal ideation via thwarted belongingness and perceived burdensomeness, whereas physical and sexual abuse were indirectly related to suicide risk via capability for suicide.LimitationsThe small sample size and the cross-sectional design are limiting factors of the present study.ConclusionsChildhood abuse is a common experience of inpatients with unipolar depression. This study showed its indirect effects on suicidal ideation and risk for suicide, mediated by the constructs of the IPTS. Further research should investigate this issue in other populations and clinicians should be aware of the devastating effects of childhood abuse.
  • The Self-Hate Scale: Development and validation of a brief measure and its
           relationship to suicidal ideation
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Adrienne I. Turnell, Daniel B. Fassnacht, Philip J. Batterham, Alison L. Calear, Michael Kyrios BackgroundThe “self” has been implicated in the development of a range of psychological disorders. While a growing body of literature has emerged exploring the Interpersonal Psychological Theory of Suicide (IPTS), little research has been conducted on the construct of self-hate and its relationship with suicidal ideation. The aims of this study were to: 1) develop and validate a brief self-report instrument of self-hate; and, 2) explore the relationship between self-hate, suicidal ideation, and the two main factors of the IPTS, perceived burdensomeness and thwarted belongingness.MethodsInitial development of the item pool involved an expert panel and the development of the Self-Hate Scale included exploratory and confirmatory factor analyses using a large community sample.ResultsA 7-item Self-Hate Scale was developed, which exhibited a reliable unidimensional factor structure. High self-hate was found to predict suicidal ideation, while the relationship between low/moderate self-hate and suicidal ideation was partially moderated by the level of thwarted belongingness. The study provided limited evidence for the IPTS’ main predictions.LimitationsWhile the current study provided support for the psychometric properties of the Self-Hate Scale, the scale will need to be replicated and validated using clinical populations.ConclusionsThe Self-Hate Scale is a brief, psychometrically valid measure of self-hate that has the potential to be useful in suicide risk assessment.
  • Predictors of change in depressive symptoms over time: Results from the
           Australian Longitudinal Study on Women's Health
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Libby Holden, Meredith Harris, Richard Hockey, Alize Ferrari, Yong Yi Lee, Annette J Dobson, Christina Lee BackgroundDepressive symptoms fluctuate over time, and are most common amongst women in early adulthood. Understanding predictors of changes in depressive symptoms among young women may inform health promotion and early intervention.MethodsData were collected at three-yearly intervals from 2000 (Survey 2) to 2012 (Survey 6) from the Australian Longitudinal Study on Women's Health. The sample comprised 7663 women, aged 22–27 in 2000, who reported any indicator of poor mental health at any wave. Generalised linear mixed models identified predictors of change in depressive symptoms (CESD-10) over each three-year period.ResultsDepressive symptoms reduced over time. In a fully adjusted model, greater reduction in symptoms was predicted by higher initial symptoms, time, higher social support, and higher self-rated general health. Slower reduction was predicted by lower education, difficulty managing on income, high or zero alcohol consumption, stress, and history of childhood sexual assault or partner violence. Motherhood predicted an increase in depressive symptoms at Survey 2 (2000), but a decrease at Survey 5 (2009).LimitationsAlthough sampling was nationally representative, there is a slight bias towards Australian-born and more educated women. Further, although validated measures are used, all data are self-report.ConclusionsFluctuations in depressive symptoms among young women are related to fixed and time-varying factors spanning multiple health and social domains. A range of factors, including education and financial resources, promotion of positive social support systems, and encouragement of health promoting lifestyles, might serve to promote young women's mental health and thus to reduce pressure on clinical services.
  • HCN channels: New targets for the design of an antidepressant with rapid
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Pan Luo, GuoFang He, Dong Liu Background: Major depressive disorder (MDD) is a prevalent neuropsychiatric disease that carries a staggering global burden. Although numerous antidepressants are available on the market, unfortunately, many patients die by committing suicide as a result of the therapeutic lag between treatment initiation and the improvement of depressive symptoms. This therapeutic lag highlights the need for new antidepressants that provide rapid relief of depressive symptoms.Method: In this review, we discuss the seminal researches on hyperpolarization-activated cyclic nucleotide-gated (HCN) channels in animal models of depression and highlight the substantial evidence supporting the development of rapid-acting antidepressants targeting HCN channels.Results: HCN channels are associated with the risk of depression and targeting HCN channels or its auxiliary subunit tetratricopeptide repeat-containing Rab8b-interacting protein (TRIP8b) function may exert a rapid antidepressant-like effect.Conclusions: Compounds acting on HCN subunits or the TRIP8b–HCN interaction site may be excellent candidates for development into effective drugs with rapid antidepressant action.
  • REM sleep fragmentation associated with depressive symptoms and genetic
           risk for depression in a community-based sample of adolescents
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Anu-Katriina Pesonen, Michael Gradisar, Liisa Kuula, Michelle Short, Ilona Merikanto, Riin Tark, Katri Räikkönen, Jari Lahti IntroductionFragmented REM sleep may impede overnight resolution of distress and increase depressive symptoms. Furthermore, both fragmented REM and depressive symptoms may share a common genetic factor. We explored the associations between REM sleep fragmentation, depressive symptoms, and a polygenic risk score (PRS) for depression among adolescents.MethodsAbout 161 adolescents (mean age 16.9 ± 0.1 years) from a birth cohort underwent a sleep EEG and completed the Beck Depression Inventory-II the same day. We calculated PRSes for depressive symptoms with PRSice 1.25 software using weights from a recent genome-wide association study for dimensions of depressive symptoms (negative emotion, lack of positive emotion and somatic complaints). REM fragmentation in relation to entire REM duration was manually calculated from all REM epochs. REM latency and density were derived using SomnoMedics DOMINO software.ResultsPRSes for somatic complaints and lack of positive emotions were associated with higher REM fragmentation percent. A higher level of depressive symptoms was associated with increased percent of REM fragmentation and higher REM density, independently of the genetic risks. Belonging to the highest decile in depressive symptoms was associated with a 2.9- and 7.6-fold risk of belonging to the highest tertile in REM fragmentation and density. In addition, higher PRS for somatic complaints had an independent, additive effect on increased REM fragmentation.LimitationA single night's sleep EEG was measured, thus the night-to-night stability of the REM fragmentation-depressive symptom link is unclear.ConclusionDepressive symptoms and genetic risk score for somatic complaints are independently associated with more fragmented REM sleep. This offers new insights on the quality of sleep and its relation to adolescents’ mood.
  • Prevalence and related influencing factors of depressive symptoms among
           empty-nest elderly in Shanxi, China
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Chichen Zhang, Yaqing Xue, Huining Zhao, Xiao Zheng, Ruifang Zhu, Yufeng Du, Jianzhong Zheng, Tingzhong Yang BackgroundIn China, aging has become a serious social problem, and the number of empty-nest elderly is on the rise. The aim of this study is to clarify the prevalence of depressive symptoms among empty-nest elderly in Shanxi province and evaluate the effects of sociodemographic factors and health-promoting lifestyles so as to provide a scientific reference for preventing and intervening their depression.MethodsA cross-sectional study, which used a multi-stage random cluster sampling way, was conducted among 4901 empty-nest elderly in Shanxi. An independent t-test and a chi square test were used to compare the sociodemographic factors, depression scores, and health-promoting lifestyle scores of the empty-nest elderly. Multinomial logistic regression was used to analyze the potential influencing factors for depression.ResultsThe prevalence of depressive symptoms in the population was 64.2%. Among all participants 1,776 (36.2%) had mild depression, 1,236 (25.2%) had moderate depression, and 135 (2.8%) had severe depression. The health-promoting lifestyle of the empty nesters in this study was at the medium level (2.51 ± 0.47). Gender, education level, old-age provision model, exercise frequency, chronic disease, relationships with children, self-care ability, and health-promoting lifestyles were found to be influencing factors of depression and all variables had different effects on different degrees of depression.LimitationsThis was a cross-sectional study, so the results cannot establish causal relationships among the study variables.ConclusionsDepression was prevalent among the empty-nest elderly in Shanxi. Maintaining good interpersonal relationships, developing extensive interests, and maintaining healthy lifestyles including good nutrition habits and regular exercises can reduce the incidence of depression among empty nesters.
  • Non-Suicidal self-injury and suicide in depressed Adolescents: Impact of
           peer victimization and bullying
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Genesis A. Vergara, Jeremy G. Stewart, Elizabeth A. Cosby, Sarah Hope Lincoln, Randy P. Auerbach Background: While prior research has demonstrated that peer victimization and bully perpetration contribute to non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs), it remains unclear whether these interpersonal processes differentiate self-injuring adolescent suicide ideators and attempters.Methods: The study included adolescents aged 13–18 years (n = 223; M = 15.31, SD = 1.34) recruited from an acute inpatient program. Participants were divided into two groups: (1) NSSISI (n = 106): endorsed past year NSSI, current suicide ideation, and no lifetime suicide attempts and (2) NSSISI+SA (n = 117): endorsed past year NSSI, current suicide ideation, and lifetime suicide attempts. Adolescents completed clinical interviews (i.e., mental disorders, NSSI, and STBs) and self-report measures assessing peer victimization, bully perpetration, and depression severity.Results: NSSISI+SA youth reported higher levels of peer victimization and bully perpetration than NSSISI youth (ps 
  • The effectiveness and cost-effectiveness of e-health interventions for
           depression and anxiety in primary care: A systematic review and
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Btissame Massoudi, Floor Holvast, Claudi L.H. Bockting, Huibert Burger, Marco H. Blanker PurposePsychological interventions are labor-intensive and expensive, but e-health interventions may support them in primary care. In this study, we systematically reviewed the effectiveness and cost-effectiveness of e-health interventions for depressive and anxiety symptoms and disorders in primary care.MethodsWe searched MEDLINE, Cochrane library, Embase, and PsychINFO until January 2018, for randomized controlled trials of e-health interventions for depression or anxiety in primary care. Two reviewers independently screened the identified publications, extracted data, and assessed risk of bias using the Cochrane Collaboration's tool.ResultsOut of 3617 publications, we included 14 that compared 33 treatments in 4183 participants. Overall, the methodological quality was poor to fair. The pooled effect size of e-health interventions was small (standardized mean difference = −0.19, 95%CI −0.31 to −0.06) for depression compared to control groups in the short-term, but this was maintained in the long-term (standardized mean difference = −0.22, 95%CI −0.35 to −0.09). Further analysis showed that e-health for depression had a small effect compared to care as usual and a moderate effect compared to waiting lists. One trial on anxiety showed no significant results. Four trials reported on cost-effectiveness.LimitationsThe trials studied different types of e-health interventions and had several risks of bias. Moreover, only one study was included for anxiety.ConclusionsE-health interventions for depression have a small effect in primary care, with a moderate effect compared to waiting lists. The approach also appeared to be cost-effective for depression. However, we found no evidence for its effectiveness for anxiety.
  • Epigenetic variation at the SLC6A4 gene promoter in mother–child pairs
           with major depressive disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): M.S. Mendonça, P.M. Mangiavacchi, P.F. De Sousa, J.A.S. Crippa, A.V. Mendes, S.R. Loureiro, R. Martín-Santos, C.R. Quirino, M.M. Kanashiro, A.F.L. Rios BackgroundGenetic and epigenetic variations of the serotonin transporter gene (SLC6A4) have been related to the etiology of depression. The 5-HTTLPR polymorphism at the SLC6A4 promoter region has two variants, a short allele (S) and a long allele (L), in which the S allele results in lower gene transcription and has been associated with depression. The short S-allele of 5-HTTLPR polymorphism of this gene has been associated with depression. In addition to molecular mechanisms, exposure to early life risk factors such as maternal depression seems to affect the development of depression in postnatal life. The present study investigated the association of 5-HTTLPR polymorphism and CpG DNA methylation (5mC) levels of an AluJb repeat element at the SLC6A4 promoter region in mother–child pairs exposed to maternal depression.MethodsWe analyzed DNA samples from 60 subjects (30 mother–child pairs) split into three groups, with and without major depression disorder (DSM-IV) among children and mothers. The genotyping of 5-HTTLPR polymorphism and quantification of 5mC levels was performed by qualitative PCR and methylation-sensitive restriction enzyme digestion, and real-time quantitative PCR (MSRED-qPCR), respectively.ResultsThe sample analyzed presented a higher frequency of S allele of 5-HTTLPR (67.5%). Despite the high frequency of this allele, we did not find statistically significant differences between individuals carrying at least one S allele between the depression and healthy control subjects, or among the mother–child pair groups with different patterns of occurrence of depression. In the group where the mother and child were both diagnosed with depression, we found a statistically significant decrease of the 5mC level at the SLC6A4 promoter region.LimitationsThe limitations are the relatively small sample size and lack of gene expression data available for comparison with methylation data.ConclusionIn this study, we demonstrated a repeat element specific 5mC level reduction in mother–child pairs, concordant for the diagnosis of depression.
  • ‘The Button Question’: A mixed-methods study of whether patients want
           to keep or remove bipolar disorder and the reasons for their decision
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Siri Folstad, Warren Mansell BackgroundMany people with a diagnosis of bipolar disorder associate positive qualities with their condition, which may place a ceiling on the effectiveness of treatment and the likelihood of recovery. However, the extent to which patients would, or would not, want to be free of their bipolar disorder has not been directly assessed.MethodAn international online survey of 103 people (80 female, 23 male) with bipolar disorder assessed whether they would want to permanently remove their bipolar disorder with a ‘button press’, as well as whether they would do the same if the effect was reversible. We also coded and analysed free-text reasons for their decisions.ResultsA total of 75 individuals (73%) would permanently remove their bipolar disorder and most of these did not report that bipolar disorder was part of their identity. A smaller number, 49 (48%) of the sample, would ‘switch off’ their bipolar disorder if the effect was reversible and most of these individuals reported enhanced qualities and the ‘fun’ of mania. Distinct positive and negative qualities of bipolar disorder were identified.ConclusionsThis mixed-method analysis has revealed wide variation and contrasts in attitudes. There is a sizeable minority of individuals who would not wish to remove their bipolar disorder for specific reasons, and knowledge of these reasons can inform approaches to interventions that are tailored to the individual.
  • Escaping reality through videogames is linked to an implicit preference
           for virtual over real-life stimuli
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Jory Deleuze, Pierre Maurage, Adriano Schimmenti, Filip Nuyens, André Melzer, Joël Billieux BackgroundFrom the theory of compensatory Internet use, escapism through videogames may constitute a coping strategy that is sometimes helpful but, in some cases, maladaptive. To date, however, evidence supporting this view has been gathered only through the use of explicit self-reported questionnaires, which are known to be biased. Accordingly, the aim of the current study was to test whether the escapism motive is related to a preference for the virtual environment.MethodA laboratory task that allowed the measurement of implicit attitudes, namely, the Affect Misattribution Procedure, was created with stimuli from real world and videogames. The task was administered online with a series of questionnaire and completed by 273 online gamers from the community.ResultsParticipants had more positive attitudes toward pictures depicting virtual environments than toward those depicting real environments. Furthermore, participants who frequently used videogames to escape real life and were highly engaged in video gaming had a more pronounced positive implicit attitude toward virtual environments.DiscussionThis study contributes to a better understanding of the psychological processes underlying escapism in videogames and calls for a refinement of the escapism construct, which can be related to both problematic (i.e., potential coping strategy) and nonproblematic patterns of videogame use. Among the limitations, it should be noted that the selection of stimuli related to videogames is restricted to one genre of game, and that the participants’ environment could not be controlled due to the online design.
  • A placebo controlled treatment trial of sertraline and interpersonal
           psychotherapy for postpartum depression
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Michael W. O'Hara, Teri Pearlstein, Scott Stuart, Jeffrey D. Long, James A. Mills, Caron Zlotnick BackgroundThe purpose of the present study was to test the efficacy of sertraline and Interpersonal Psychotherapy (IPT) relative to pill placebo in a two site randomized controlled trial over a period of 12 weeks. It was hypothesized that sertraline and IPT would be more efficacious than pill placebo with respect to depression and social adjustment.Methods162 breastfeeding and non-breastfeeding women experiencing a major depressive episode in the first year postpartum from two sites in Iowa and Rhode Island were randomly assigned to IPT, sertraline-clinical management (CM), or pill placebo-CM. CM included infant-focused psychoeducation. Interview-based and self-report measures of depression and social adjustment were obtained at baseline, 4-weeks, 8-weeks, and 12-weeks of treatment. Linear mixed effects regression (LMER) was used for the longitudinal data analysis.ResultsThere was no significant effect for treatment condition associated with the primary outcome measure, the HamD-17, but there was a significant effect for sertraline-CM relative to the IPT and placebo conditions over the duration of the trial based on the General Depression scale of the Inventory of Depression and Anxiety Symptoms. There was a main effect for time in that study subjects across all three conditions showed significant improvement for the duration of the trial.LimitationsLimitations of the present study included significant non-engagement with assigned condition and differential effects of IPT across the two study sites.ConclusionsThere was improvement for all postpartum women in all conditions. The results do suggest that active interventions with or without medication delivered over a period of twelve weeks can lead to significant improvement in depression and social adjustment among postpartum identifier: NCT00602355
  • Spanish adaptation of the Dimensional Anhedonia Rating Scale (DARS)
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Elsa Arrua-Duarte, Marta Migoya-Borja, Maria L. Barrigón, Igor Barahona, David Delgado-Gomez, Philippe Courtet, Fuensanta Aroca, Sakina J. Rizvi, Sidney H. Kennedy, Lena C. Quilty, Enrique Baca-García BackgroundAnhedonia is defined as the lack of enjoyment, engagement in, or energy for life's experiences. Only two scales to measure anhedonia have been adapted for use in Spanish-speaking populations. The aim of this study was to determine the reliability and validity of the Dimensional Anhedonia Rating Scale (DARS) following translation and adaptation for Spanish population.MethodThe study sample included 134 patients over 18 years of age with a range of psychiatric diagnoses. Those with substance use, decompensated medical conditions, illiteracy, or lack of fluency in Spanish were excluded. The structure of the Spanish adaptation was evaluated through factor analysis. Internal reliability was assessed through Cronbach's alpha and validity was measured using Pearson's correlation between total scores for DARS and its subscales and SHAPS score.ResultsA strong internal consistency was observed (Cronbach alpha = 0.92 for total scale score and 0.91–0.92 for subscale scores). Similarly, a significant and strong correlation between total scores for DARS and SHAPS was found (r = 0.51, p 
  • Inflammatory cytokines and cognitive functioning in early-stage bipolar I
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Trisha Chakrabarty, Ivan J. Torres, David J. Bond, Lakshmi N. Yatham BackgroundIncreased circulating inflammatory cytokines is a replicated finding in bipolar I disorder (BDI). Pro-inflammatory cytokines such as TNFα, IL-6 and IL-1 have also been associated with poorer cognitive functioning in patients with longer illness duration. However, the effect of inflammatory cytokines on cognition in early stage patients is not yet known. Here, we investigate the relationship between cytokines and cognition in BDI patients within three years of diagnosis.MethodsSerum pro-inflammatory (TNFα, IL-6 and IL-1α) and anti-inflammatory (IL-4 and IL-10) cytokine levels were compared between 51 early stage BDI patients and 20 healthy controls. 46 patients completed neuropsychological testing, and multiple regression analysis was used to assess the association between cytokine levels and cognition after accounting for relevant clinical and demographic variables.ResultsTNFα was elevated at trend level significance in BDI patients compared to healthy controls, and was negatively associated with global cognition, processing speed, and working memory in patients. IL-6, IL-1α, IL-4 and IL-10 levels were comparable between groups and were not significantly associated with cognition.LimitationsDirect causation cannot be established in this cross-sectional study; in addition, cytokine levels were not taken on the same day as neuropsychological testing for all patients.ConclusionsTNFα may negatively impact cognition in early BDI. While replication is required in larger samples, these results suggest that inhibition of TNFα activity might be a strategy to preserve cognition in newly diagnosed BDI patients.
  • Childhood adversities and mid-late depressive symptoms over the life
           course: Evidence from the China health and retirement longitudinal study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Fan Tian, Steven Siyao Meng, Peiyuan Qiu BackgroundThe cumulative effect of childhood adversities on depressive symptoms in later life is well documented. However, there is a dearth of accurate information about this effect among Chinese population. The aim of this study is to examine the cumulative effect of childhood adversities on mid-late depressive symptoms in the Chinese population.MethodsData were drawn from the China Health and Retirement Longitudinal Study (CHARLS). We included 17,425 respondents aged 45 and over, and retrospectively collected information of childhood adversities. The depressive symptoms were assessed using a 10-item Center for Epidemiologic Studies Depression Scale (CES-D). A structural equation model was employed for analysis.ResultsParental mental health problems had a direct effect on mid-late depressive symptoms (β = 0.180, P 
  • Suicidal thoughts and behaviors and social isolation: A narrative review
           of the literature
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Raffaella Calati, Chiara Ferrari, Marie Brittner, Osmano Oasi, Emilie Olié, André F. Carvalho, Philippe Courtet BackgroundSocial isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors.MethodsWe used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: (a) systematic reviews, meta-analyses, and narrative reviews; (b) original observational studies with large samples (N ≥ 500); and (c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide.ResultsThe main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k = 23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k = 24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent.LimitationsConfounding factors can limit the weight of the results obtained in observational studies.ConclusionsData from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.
  • Family functioning, trauma exposure and PTSD: A cross sectional study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Sarah Dorrington, Helena Zavos, Harriet Ball, Peter McGuffin, Athula Sumathipala, Sisira Siribaddana, Fruhling Rijsdijk, Stephani L. Hatch, Matthew Hotopf ObjectiveOnly a minority of trauma-exposed individuals go on to develop post traumatic stress disorder (PTSD). Previous studies in high income countries suggest that maladaptive family functioning adversities (MFFA) in childhood may partially explain individual variation in vulnerability to PTSD following trauma. We test in a lower middle-income setting (Sri Lanka) whether: (1) MFFA is associated with trauma exposure; (2) MFFA moderates the association between exposure to trauma and later (a) PTSD (b) other psychiatric diagnoses; and (3) any association between MFFA and PTSD is explained by experiences of interpersonal violence, cumulative trauma exposure or comorbid psychopathology.MethodsWe conducted a population study of 3995 twins and 2019 singletons residing in Colombo, Sri Lanka. Participants completed the Composite International Diagnostic Interview, including nine traumatic exposures and a questionnaire on MFFA.Results23.4% of participants reported exposure to MFFA. We found that (1) MFFA was strongly associated with trauma exposure (2) MFFA moderates the association between trauma exposure and both (a) PTSD and (b) other DSM psychiatric diagnosis. (3) This was not explained by interpersonal violence, cumulative trauma exposure or other psychopathology.ConclusionsMFFA moderates the association between trauma and PTSD, and the association between trauma and non-PTSD psychopathology.
  • Application of a transdiagnostic treatment for emotional disorders to body
           dysmorphic disorder: A randomized controlled trial
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Banafsheh Mohajerin, Maryam Bakhtiyar, Olenka S. Olesnycky, Behrouz Dolatshahi, Fereshteh Motabi BackgroundBody dysmorphic disorder (BDD) is a common disorder which is associated with a high rate of comorbidity and functional impairment. Although research shows that cognitive-behavioral therapy can be an efficacious treatment for BDD, there is growing evidence that dysregulated emotion is a core deficit. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a transdiagnostic, emotion focused cognitive-behavioral therapy protocol that has been developed to target emotion regulation processes that play an important role in the development and maintenance of many emotional disordersMethods: In the present study, 128 patients meeting criteria for BDD were randomized to either the UP (n = 64) or waitlist/treatment-as-usual (WL/TAU) condition. Diagnoses were determined using semi-structural interviews and patients also completed the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI), the Difficulties in Emotion Regulation Scale (DERS), the Beck Depression Inventory (BDI) and the Clinical Global Impression (CGI).ResultsRepeated measure ANOVA indicated that the UP significantly decreased depression, BDD symptoms and body-related anxiety, as well as significantly improving emotional regulation all with large effect sizes compared to the TAU/WL condition. Treatment gains as well as remission of comorbid conditions were maintained at the three-month follow-up.Limitations: Our study limitations include restricted follow-up periods and excluding participants who were actively suicidal.Conclusions: To our knowledge, this is the first examination of the UP for BDD, and results suggest that this disorder shares common mechanisms with other disorders of emotion, and that the UP may be an additional efficacious treatment for this condition.
  • A naturalistic study exploring mental health outcomes following
           trauma-focused treatment among diverse survivors of crime and violence
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Bita Ghafoori, Melissa Gordon Wolf, Karen Nylund-Gibson, Erika D. Felix BackgroundAlthough considerable research has tested evidence-based practices in clinical trials, research is needed on the use of trauma-focused treatments by victims of crime and violence in naturalistic settings. This study investigated four trauma-focused treatments, prolonged exposure therapy (PE), cognitive behavioral therapy (CBT), eclectic therapy, and person-centered therapy (PCT), and assessed treatment dropout and symptom improvement over five assessment time-points.MethodsDescriptive comparisons and pattern mixture multigroup growth models were used to assess differences between treatments on time in treatment, rate of dropout, and improvement in posttraumatic stress (PTSD) and depression symptoms in an outpatient sample of 526 clients seeking routine clinical care.ResultsPCT was significantly associated with the highest number of therapy sessions completed and the lowest rate of dropout (41.75%) compared to CBT and eclectic treatments. All treatment groups reported PTSD symptom improvement with no significant differences based on therapy type. For depression, the rate of improvement for clients in PCT who dropped out of treatment after session 3 was significantly steeper than the rate of improvement for clients in eclectic treatment who dropped out of treatment after session 3. Clients who stayed in treatment longer generally had larger decreases in symptoms compared to those who dropped out earlier.LimitationsThe small sample size in each of the treatment groups may have limited power to detect change.ConclusionsSeveral trauma-focused treatments offered in a community-based setting may result in significant symptomatic improvement.
  • Early versus late wake therapy improves mood more in antepartum versus
           postpartum depression by differentially altering melatonin-sleep timing
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Barbara L. Parry, Charles J. Meliska, Ana M. Lopez, Diane L. Sorenson, L. Fernando Martinez, Henry J. Orff, Richard L. Hauger, Daniel F. Kripke BackgroundPeripartum major depression (MD) disables mothers and impairs emotional and neurocognitive development of offspring. We tested the hypothesis that critically-timed wake therapy (WT) relieves peripartum MD by altering melatonin and sleep timing, differentially, in antepartum vs. postpartum depressed patients (DP).MethodsIn a university clinical research center, we initially randomized 50 women – 26 antepartum (17 healthy comparison-HC, 9 DP) and 24 postpartum (8 HC, 16 DP) – to a cross-over trial of one night of early-night wake therapy (EWT: sleep 3:00–7:00 am) vs. late-night wake therapy (LWT: sleep 9:00 pm–01:00 am). Ultimately, we obtained mood, overnight plasma melatonin and polysomnography for: 15 antepartum women receiving EWT, 18 receiving LWT; 15 postpartum women receiving EWT, 14 receiving LWT.ResultsEWT improved mood more in antepartum vs. postpartum DP in conjunction with reduced (normalized) melatonin-sleep phase-angle differences (PADs) due to delayed melatonin onsets and advanced sleep onsets, and increased (from baseline) total sleep times (TST). LWT improved mood more in postpartum vs. antepartum DP in conjunction with increased TST.LimitationsSmall samples potentially rendered the study underpowered to detect group differences, making confirmation with larger samples essential. Sufficient follow-up data were not available in most women to document the duration of the mood response to wake therapy.ConclusionsEWT benefitted antepartum DP more by realigning melatonin and sleep timing, whereas LWT benefitted postpartum DP more by increasing TST. Thus, consistent with precision medicine aims, maximum mood benefits accrue from timing sleep/wake interventions to specific peripartum circadian pathophysiologies.
  • Decreased plasma glial cell line-derived neurotrophic factor level in
           major depressive disorder is associated with age and clinical severity
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Jiaze Sun, Lingtao Kong, Feng Wu, Yange Wei, Yue Zhu, Zhiyang Yin, Xin Deng, Xiaowei Jiang, Yanqing Tang, Fei Wang BackgroundGlial cell line-derived neurotrophic factor (GDNF) as a neurotrophic factor closely related to depression is able to promote the growth, proliferation, differentiation, and survival of multiple neurons. Clinical features, recurrence rates and suicide rates are significant different in major depressive disorder (MDD) according to age. GDNF level changes in the peripheral blood has been reported in patients with MDD. In this study, we aimed to investigate whether GDNF levels differentiated within various age groups and its relationship with age/clinical severity.MethodMDD subjects and healthy controls (HC) are divided into younger (age 13–24 years) group (yMDD n = 35, yHC n = 44) and older (age 25–45 years) group (oMDD n = 30, oHC n = 55) based on the age of brain maturity. Clinical symptom severity was evaluated by the Hamilton Depression Rating Scale (HAMD-17) and the Hamilton Anxiety Rating Scale (HAMA-17). The levels of plasma GDNF were compared within subgroups.ResultsPlasma GDNF levels in yMDD patients were significantly decreased compared to yHC (yMDD 1.55 ± 0.46pg/ml, yHC 1.77 ± 0.47pg/ml, p 
  • Sex-specific effects of gain-of-function P2RX7 variation on
           bipolar disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Stacey J. Winham, William V. Bobo, Jiajia Liu, Brandon Coombes, Lena Backlund, Mark A. Frye, Joanna M. Biernacka, Martin Schalling, Catharina Lavebratt BackgroundPatients with bipolar disorder demonstrate sex differences in clinical presentation, particularly in the sub-phenotypes related to periodicity of mood episodes, such as rapid cycling. Additionally, recent studies have linked P2RX7 gene variants with the risk of rapid cycling in clinical cohorts of patients with bipolar disorder, as well as other mood disorders. However, little is known about potential sex differences in the relationship between variants in P2RX7 and bipolar disorder.MethodsWe investigated sex-specific genetic associations between variants of P2RX7 (rs1621388 and rs2230912) in 756 patients with bipolar disorder and 787 control patients matched on age, sex, and ancestry. We examined sex-specific genetic associations with bipolar disorder by comparing cases and controls, as well as rapid cycling of mood episodes in cases. Findings were replicated in an independent dataset.ResultsP2RX7 variants implying an increased pore activity were more common in bipolar disorder, in females but not in males. Neither P2RX7 variants associated with rapid cycling among bipolar patients.LimitationsLow sample size limited power for tests of SNP by sex interaction, and data about the onset of rapid cycling and the timing of medication use were not available.ConclusionThe effects of P2RX7 variants on bipolar disorder may be sex-specific, with increased P2X7 activity potentially elevating risk for bipolar disorder in females. Future research to examine the effect of P2RX7 on bipolar disorder should consider sex-specific effects.
  • Familial and social transmission of suicidal behavior in older adults
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Laura B. Kenneally, Anna Szűcs, Katalin Szántó, Alexandre Y. Dombrovski BackgroundBoth biological and social mechanisms have been implicated in the transmission of suicidal behavior in younger and middle-aged adults. Yet, while suicide rates rise with age, it is not clear whether such mechanisms operate in late life. Thus, we looked for evidence of social and familial suicidal transmission in elderly with late- vs. early-onset suicidal behavior by examining exposure to suicidal behavior within biological relatives and broader social networks.MethodParticipants were 356 adults, aged 50 or older (mean: 67), divided into five groups: early-onset suicide attempters (first lifetime attempt before age 60), late-onset attempters, suicide ideators (without attempt history), depressed non-suicidal controls, and non-psychiatric controls. History of suicidal behavior in one's biological relatives and friends/unrelated kin was assessed via clinical interview, and group differences were examined via generalized linear mixed-effects models.ResultsThere was a main effect of group (χ24 = 18.38, p 
  • The relationship of anxious and depressive symptoms in Parkinson's disease
           with voxel-based neuroanatomical and functional connectivity measures
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Haobo Zhang, Yuehong Qiu, Yuejia Luo, Pengfei Xu, Zhihao Li, Wanlin Zhu, Qizhu Wu, Wei Tao, Qing Guan, Fuyong Chen BackgroundAnxiety and depression are two frequent comorbidities of Parkinson's disease (PD). However, the underlying neural mechanism is still unclear and the studies on their neural correlates were insufficient.MethodsUsing voxel-based neuroanatomical and functional connectivity (FC) measures, i.e. grey matter volume, fractional anisotropy, and weighted degree centrality (WD), we examined their correlations with the severity levels of anxious and depressive symptoms in 36 PD patients.ResultsPositive correlations were shown between anxiety and the WDs in the left amygdala, and between depression and short-ranged WDs in the left parahippocampal gyrus. Using these two regions as the seeds, we found that the severity levels of anxiety and depression were positively correlated with the FCs between the two seeds and the areas in the default mode network (DMN), while negatively correlated with the FCs between the two seeds and the prefrontal and superior temporal cortices. Anxiety was also positively correlated with the FC between the amygdala and the superior parietal lobule.LimitationsThe severity levels of anxious and depressive symptoms of our participants is relatively mild than some previous studies. The cross-sectional design of this study cannot clarify the etiological relationship between PD and two comorbidities.ConclusionsOur results were in line with the key roles of the amygdala and parahippocampal gyrus in anxiety and depression, and reflected the distinct effects of the DMN, prefrontal and superior temporal cortices, and sensory-motor regions on emotional regulation. The identification of these neural substrates might assist clinical monitoring mood disturbances in PD.
  • The multidimensional nature of adult social inhibition: Inhibition,
           sensitivity and withdrawal facets of the SIQ15
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Johan Denollet, Stefanie Duijndam BackgroundSocial inhibition may promote emotional problems in children, but little is known about this disposition in adults. Our research builds on a theory-based model to suggest that adult social inhibition involves distinct behavioral (inhibition), cognitive (sensitivity), and affective (withdrawal) characteristics.MethodsA total of 1385 adults completed measures of social inhibition, emotional distress, and social stress. Factor analyses, reliability estimates and regression analyses were used to examine the robustness of our model, and the validity of the 15-item Social Inhibition Questionnaire (SIQ15).ResultsIn Study 1 (N = 1180; Mage 46.9 years; 52% women), factor analysis confirmed that behavioral inhibition, interpersonal sensitivity, and social withdrawal reflected distinct facets of social inhibition. Next, we developed the SIQ15 that covers these facets with 5 items each; e.g. has difficulty making contact; expects negative reactions from others; keeps others at a distance. Study 2 (N = 209; Mage 20.3 years; 77% women) showed that the SIQ15 and its 5-item Inhibition, Sensitivity and Withdrawal facet scales were internally consistent (Cronbach's α between 0.86/0.94) and stable over time (test–retest between r = 0.73/0.78). The SIQ15 facets differentially predicted related inhibition (Behavioral Inhibition Scale), rumination (Penn State Worry Questionnaire) and withdrawal (Personality Inventory for DSM-5) scores at 6 months follow-up. Younger age and having no partner were associated with more social inhibition.LimitationsFindings are based on self-report; experimental and prospective studies are needed to further validate our inhibition model.ConclusionsInhibition, sensitivity, and withdrawal are distinct manifestations of adult social inhibition that can be reliably assessed with the SIQ15. Research needs to examine how this multidimensional nature of social inhibition has an effect on stress, health, and wellbeing.
  • Are children with social anxiety disorder more likely than children with
           other anxiety disorders to anticipate poor social performance and reflect
           negatively on their performance'
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Brynjar Halldorsson, Saskia Castelijn, Cathy Creswell BackgroundThe cognitive theory of social anxiety disorder (SAD) suggests that adults with SAD have a tendency to anticipate poor social performance and reflect negatively on their performance following a social event. While a number of studies with socially anxious adults have supported the role of poor performance anticipation and post-event rumination in SAD, to date, only a few studies have addressed whether this also applies to children with SAD.MethodsChildren (7–12 years) diagnosed with SAD (n = 40), other anxious children (n = 40) and non-anxious children (n = 34) were exposed to a social stressor speech task and their pre- and post-performance appraisals assessed, taking into account objective performance ratings.ResultsAlthough observers rated some aspects of performance as significantly worse among children with SAD than children with other anxiety disorders, children with SAD were not more likely than their anxious or non-anxious peers to show a general bias in pre- or post-performance appraisals. Furthermore, children with SAD were just as likely as their anxious and non-anxious peers to recognize good performance but were more critical of themselves when their performance was poor.LimitationsThe speech task did not involve a same-age peer. Participants were relatively affluent group of predominantly non-minority status. Specificity for SAD in relation to other anxiety disorders remains unclear.ConclusionsFocusing on counteracting pre- and post-event social performance appraisals may potentially be inappropriate for childhood SAD. Children with SAD might benefit from interventions that focus on helping them to become less critical of themselves after social interactions have not gone well.
  • Age and sex differences in the effects of peer victimization on depressive
           symptoms: Exploring sleep problems as a mediator
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Ling-Yin Chang, Chi-Chen Wu, Linen Nymphas Lin, Hsing-Yi Chang, Lee-Lan Yen BackgroundPeer victimization contributes to an elevated risk of adolescent depression. Although theoretical evidence has noted that peer victimization may disrupt sleep and subsequently increase levels of depressive symptoms, this pathway has never been tested. This study explores a novel mechanism leading from peer victimization to depressive symptoms through sleep problems and considers whether the direct and indirect pathways vary by age and sex of adolescents.MethodsData were from 4072 adolescents (2042 males, 2030 females; age range 14–19 years) residing in northern Taiwan. Mediation analyses were first conducted to understand the mediating role of sleep problems in the association between peer victimization and depressive symptoms for males and females, respectively. Moderated mediation analyses were then applied to test age differences in the direct and indirect pathways from peer victimization to depressive symptoms.ResultsSleep problems mediated the association between peer victimization and depressive symptoms in adolescent females but not in males. Age further moderated the indirect pathway from peer victimization to depressive symptoms through sleep problems, such that the mediating effects of sleep problems increased with age and were only significant in older females. No age differences were observed for the direct effects of peer victimization on depressive symptoms in either males or females.LimitationsStudy was not designed to infer causality and all variables were assessed by self-report measures.ConclusionsOur analyses revealed age and sex differences in the link from peer victimization to depressive symptoms through sleep problems. Efforts to reduce depressive symptoms in adolescent females who have experienced peer victimization may be made more effective by targeting sleep problems, especially in older female adolescents.
  • Longitudinal decreases in suicidal ideation are associated with increases
           in salience network coherence in depressed adolescents
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Jaclyn Schwartz, Sarah J. Ordaz, Tiffany C. Ho, Ian H. Gotlib BackgroundSuicidal ideation (SI) is an important predictor of suicide attempt, yet SI is difficult to predict. Given that SI begins in adolescence when brain networks are maturing, it is important to understand associations between network functioning and changes in severity of SI.MethodsThirty-three depressed adolescents were administered the Columbia-Suicide Severity Rating Scale to assess SI and completed resting-state fMRI at baseline (T1) and 6 months later (T2). We computed coherence in the executive control (ECN), default mode (DMN), salience (SN), and non-relevant noise networks and then examined the association between changes in brain network coherence and changes in SI severity from T1 to T2.ResultsA greater reduction in severity of SI was associated with a stronger increase in SN coherence from T1 to T2. There were no associations between the other networks and SI.LimitationsWe cannot generalize our findings to more psychiatrically diverse samples. More time-points are necessary to understand the trajectory of SI and SN coherence change.ConclusionsOur finding that reductions in SI are associated with increases in SN coherence extends previous cross-sectional results documenting a negative association between SI severity and SN coherence. The SN is involved in coordinating activation of ECN and DMN in response to salient information. Given this regulatory role of the SN, the association between SN coherence and SI suggests that adolescents with reduced SN coherence might more easily engage in harmful thoughts. Thus, the SN may be particularly relevant as a target for treatment applications in depressed adolescents.
  • A reliability generalization meta-analysis of the child and adolescent
           perfectionism scale
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): María Vicent, María Rubio-Aparicio, Julio Sánchez-Meca, Carolina Gonzálvez BackgroundPerfectionism is a prevalent disposition of personality involved in the development and maintenance of a wide range of psychological disorders. The Child and Adolescent Perfectionism Scale (CAPS) is the most usually applied test to assess perfectionism in children and adolescents. This study aimed: (a) to conduct a reliability generalization meta-analysis to estimate the average reliability of the CAPS scores and to search for characteristics of the studies that may explain the variability among reliability estimates, and (b) to estimate the reliability induction rate of the CAPS.MethodAn exhaustive search allowed to select 56 studies that reported alpha coefficients with the data at hand for the CAPS.ResultsThe average alpha coefficients were 0.87, 0.84 and 0.83, respectively for the CAPS total score and its two subscales, Socially Prescribed Perfectionism (SPP) and Self-Oriented Perfectionism (SOP). Regarding O'Connor's version, the average reliability coefficients were 0.82, 0.74 and 0.73, respectively, for SPP, SOP-Critical and SOP-Strivings. Some study characteristics (ethnicity, language, mean age and standard deviation of the scores, psychometric vs applied) showed a statistical association with the reliability coefficients of SPP and SOP. The reliability induction rate was 29.8%.LimitationsDue to the scarcity of studies, we could not examine the reliability scores of other versions of the CAPS and test-retest reliability.ConclusionsIn terms of reliability, the original version of the CAPS present better results than O'Connor's version. The original version of the CAPS is a reliable instrument to be employed with general research purposes, but not for clinical practice.
  • Discrimination and suicidality among racial and ethnic minorities in the
           United States
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Hans Oh, Andrew Stickley, Ai Koyanagi, Rebecca Yau, Jordan E. DeVylder BackgroundOver the past decade, suicide rates have increased among certain racial/ethnic minority groups in the United States. To better understand suicide vulnerability among people of color, studies have examined the relations between social risk factors—such as discrimination—and suicidal thoughts and behaviors. However, the literature has been inconsistent, calling for more population studies.MethodsThis study analyzed data from two surveys: (1) The National Survey of American Life; and (2) The National Latino and Asian American Survey, which taken together are representative of Black, Latino, and Asians in the United States. Multivariable logistic regression models were used to examine the association between levels of discrimination on the Everyday Discrimination Scale and suicidal thoughts and behaviors. Additional models tested for effect modification by race and by psychiatric diagnosis.ResultsWe found that individuals who reported the highest levels of discrimination had greater odds of reporting lifetime suicidal thoughts, plans, and attempts, when compared with people who did not report discrimination, after adjusting for socio-demographic characteristics. Notably, discrimination increased odds of reporting an unplanned suicide attempt and a suicide attempt without the intent to die. Adjusting for psychiatric diagnoses attenuated these effects. We found no evidence of effect modification by race or by psychiatric diagnosis.LimitationsData were cross-sectional, which did not allow for causal inferences.ConclusionsFuture translational research can explore how screening for discrimination may help identify individuals and groups of racial/ethnic minorities at risk for suicidal thoughts and behaviors.
  • Validation of the University of California San Diego Performance-based
           Skills Assessment (UPSA) in major depressive disorder: Replication and
           extension of initial findings
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Michael Cronquist Christensen, Lasse Breuning Sluth, Roger S. McIntyre BackgroundThe University of California San Diego Performance-based Skills Assessment (UPSA) has been validated as a functional measure in patients with major depressive disorder (MDD). The study herein aims to both replicate and extend the initial validation incorporating data sets from two additional studies.MethodsNCT02279966 and NCT02272517 were multinational, double-blind, placebo-controlled studies in adult outpatients with moderate-to-severe MDD and a current major depressive episode of ≥3 months and less than 1 year, respectively. Subjects were randomized to vortioxetine (10 or 20 mg), placebo or active reference drug (paroxetine [20 mg], or escitalopram [10 or 20 mg]) for 8 weeks. Pearson correlation coefficients were estimated for baseline UPSA-Brief (UPSA-B), demographic/disease characteristics, Montgomery-Åsberg Depression Rating Scale (MADRS), Perceived Deficit Questionnaire-20 items (PDQ-20), and Digit Symbol Substitution Test (DSST), to examine construct validity. Distribution- and anchor-based methods examined clinically important difference (CID) threshold. A pooled analysis with data from NCT01564862 (initial validation study) was performed to increase the statistical power of the estimations.ResultsIn pooled analysis of the two new studies, UPSA-B score correlated with the DSST (r = 0.32, P 
  • Prevalence of depressive symptoms among adolescents in secondary school in
           mainland China: A systematic review and meta-analysis
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Xinfeng Tang, Suqin Tang, Zhihong Ren, Daniel Fu Keung Wong BackgroundThe objective of the study reported here is to systematically estimate the prevalence of depressive symptoms among adolescents in secondary schools in mainland China.MethodLiterature searches were conducted in both English and Chinese databases from database inception to January 2018. This meta-analysis used a random-effects model to estimate the prevalence of depressive symptoms.ResultsFifty-one eligible studies (n = 144,060) using probability sampling were identified. The results revealed a pooled prevalence of depressive symptoms of 24.3% (95% CI, 21.3%–27.6%), with high between-studies heterogeneity (Q = 9909, I² = 99.5%, p 
  • Memory bias and its association with memory function in women with
           posttraumatic stress disorder
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Mariko Itoh, Hiroaki Hori, Mingming Lin, Madoka Niwa, Keiko Ino, Risa Imai, Sei Ogawa, Mie Matsui, Toshiko Kamo, Yoshiharu Kim BackgroundMemory abnormalities are among a central feature of posttraumatic stress disorder (PTSD). It is suggested that individuals with PTSD exhibit memory bias; while evidence shows poor memory function in these individuals. We aimed to examine memory bias in PTSD patients relative to controls and to explore an association between memory bias and memory function.MethodsForty-six women with DSM-IV PTSD, most of whom developed the disorder after interpersonal violence, and 68 non-trauma-exposed healthy control women were studied. Memory bias was assessed by a recognition memory task using negative, neutral, and positive words. Memory function was assessed by a standardized neuropsychological test battery. Depression and anxiety symptoms were assessed by self-report measures.ResultsCompared to controls, patients showed significantly greater negative bias scores (i.e., correctly recognized rates for negative words minus those for neutral words) and poorer memory function. Negative bias scores were significantly correlated with worse memory function in patients. When patients were divided into those with lower vs. normal memory function, the former patients had significantly greater negative bias than the latter patients and controls. Memory bias scores in patients were not significantly correlated with depression or anxiety symptoms, nor were they significantly different between patients with comorbid major depressive disorder and those without.LimitationsThe cross-sectional design and absence of the trauma-exposed non-PTSD group limited our findings.ConclusionsPTSD patients have greater negative memory bias, which can be associated with poorer memory function. Our findings may provide an insight into the nature of memory abnormalities in PTSD.
  • The impact of depressive comorbidity on neural plasticity following
           cognitive-behavioral therapy in panic disorder with agoraphobia
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Stefanie L. Kunas, Yunbo Yang, Benjamin Straube, Tilo Kircher, Alexander L. Gerlach, Bettina Pfleiderer, Volker Arolt, André Wittmann, Andreas Stroehle, Hans-Ulrich Wittchen, Ulrike Lueken Background: Depressive disorders are a frequent comorbidity of panic disorder with agoraphobia (PD/AG). Cognitive-behavioral therapy (CBT) for PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbidities. However, as depressive comorbidities can confound fear circuitry activation (i.e. amygdalae, insulae, anterior cingulate cortex) in PD/AG, we investigated whether comorbid depressive disorders alter neural plasticity following CBT.Methods: Within a randomized, controlled clinical trial on exposure-based CBT, forty-two PD/AG patients including fifteen (35.7%) with a comorbid depressive disorder (PD/AG + DEP) participated in a longitudinal functional magnetic resonance imaging (fMRI) study. A differential fear conditioning task was used as probe of interest. A generalized psycho-physiological interaction analysis (gPPI) served to study functional connectivity patterns.Results: After CBT, only PD/AG patients without comorbid depressive disorders (PD/AG-DEP) showed reduced activation in the left inferior frontal gyrus (IFG) extending to the insula. While PD/AG-DEP patients showed enhanced functional connectivity (FC) between the left IFG and subcortical structures (anterior cingulate cortex, thalamus and midbrain), PD/AG + DEP patients exhibited increased FC between the left IFG and cortical structures (prefrontal, parietal regions). In both groups, FC decreased following CBT.Limitations: Primary depressed and medicated patients were excluded. Major depression and dysthymia were collapsed.Conclusions: Reduced activation in the left IFG, as previously shown in PD/AG, appears to be a specific substrate of CBT effects in PD/AG-DEP patients only. Differential patterns of FC pertaining to fear circuitry networks in patients without depression vs. cognitive networks in patients with comorbid depression may point towards different pathways recruited by CBT as a function of comorbidity.
  • Course of depressive symptoms and associated factors in people aged 65+ in
           Europe: A two-year follow-up
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Josep L. Conde-Sala, Josep Garre-Olmo, Laia Calvó-Perxas, Oriol Turró-Garriga, Joan Vilalta-Franch BackgroundThe epidemiology of depressive disorders presents notable differences among European countries. The objectives of the study are to determine the prevalence, incidence, persistence and remission rates of depressive symptoms and to identify risk factors and differences between four European regions.MethodProspective cohort design using data from waves 5 and 6 (2013–15) of the Survey of Health, Ageing and Retirement in Europe. Sample size included 31,491 non-institutionalized adults aged 65+. Depressive symptoms were assessed using the EURO-D.ResultsThe prevalence of depressive symptoms (EURO-D ≥4) was 29.8% and 31.5%in waves 5 and 6, respectively. The risk factors associated depressive symptoms were poorer self-rated health, loneliness, impairment in ADL, female gender and financial difficulties. Incidence was 6.62 (99.9% CI: 6.61–6.63)/100 person-years and the persistence and remission rates were 9.22 and 5.78, respectively. Regarding the differences between European regions, the incidence (4.93 to 7.43) and persistence (5.14 to 11.86) rates followed the same ascending order: Northern, Eastern, Continental and Southern. The remission presented higher rates in the Eastern and Southern (6.60–6.61) countries than in the Northern and Continental (4.45–5.31) ones.LimitationsThe EURO-D scale is unable to distinguish between clinically relevant depressive symptoms and major depression.ConclusionThe risk factors related to the incidence of depressive symptoms differed across European regions. In countries of eastern and southern Europe the most important predictors were female gender and impairment in ADL. Poorer self-rated health and older age were more relevant in the Northern countries, and chronic diseases were a key factor in the Continental region.
  • Understanding the effects of emotional reactivity on depression and
           suicidal thoughts and behaviors: Moderating effects of childhood adversity
           and resilience
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Benjamin G. Shapero, Amy Farabaugh, Olga Terechina, Stephanie DeCross, Joey C. Cheung, Maurizio Fava, Daphne J. Holt BackgroundEarly adulthood is a period of increased risk for depression and suicide. Emotional reactivity (a tendency to react to stress with increases in negative affect and maladaptive interpretations of events) is an important risk factor for these outcomes that has been under-studied. We hypothesized that elevated emotional reactivity would be associated with higher levels of depressive symptoms and suicidal thoughts and behaviors. Further, we hypothesized that experiences of childhood maltreatment would amplify this relationship, whereas the presence of resilience would act as a buffer.Methods1703 young adults (Mean Age = 19.56 years), 71% female) completed well-validated self-report questionnaires at a single time point.ResultsHigher emotional reactivity was directly associated with higher levels of depressive symptoms and suicidal thoughts and behaviors. Further, resilience levels significantly moderated the relationships between emotional reactivity and depressive symptoms and suicidal thoughts and behaviors. Finally, childhood trauma significantly moderated the relationship between emotional reactivity and suicidal thoughts and behaviors only.LimitationsThis study was cross-sectional in design and relied upon self-report measures only.ConclusionsThe current study demonstrates an association between emotional reactivity, depressive symptoms, and suicidal thoughts and behaviors during emerging adulthood. Whereas a history of childhood maltreatment may amplify the relationship between emotional reactivity, depression, and suicidal thoughts and behaviors, certain qualities associated with resilience may buffer against the effects of emotional reactivity. Future studies can identify the resilience-promoting factors that are most protective and develop and test interventions that can potentially augment those factors.
  • Insomnia and risk for suicidal behavior: A test of a mechanistic
           transdiagnostic model in veterans
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Peter C. Britton, Jessica M. McKinney, Todd M. Bishop, Wilfred R. Pigeon, Jameson K. Hirsch BackgroundInsomnia has been shown to have direct and indirect associations with suicidal ideation, attempts, and death in U.S. military and veteran populations. However, transdiagnostic models of insomnia and psychopathology have not been used to examine the contribution of psychopathology.MethodThe present study is a secondary analysis examining the associations among insomnia symptoms, posttraumatic stress disorder (PTSD) and depressive symptoms, interpersonal theory of suicide variables, and risk for suicidal behavior in community veterans (n = 392). Serial mediation was used to test sequential associations, allowing for examination of direct and indirect associations.ResultsThe model with insomnia, PTSD, and depressive symptoms, and thwarted belongingness, accounted for 29% of the variance in risk. Insomnia symptoms had an indirect association through PTSD and depressive symptoms, and thwarted belongingness. The model with insomnia, PTSD, and depressive symptoms, and perceived burdensomeness accounted for 35% of the variance in risk. Insomnia symptoms had an indirect association through PTSD and depressive symptoms, and perceived burdensomeness.LimitationsData are cross-sectional, precluding the testing of causal associations.ConclusionsIn veterans, insomnia symptoms may be associated with increased PTSD and depressive symptoms, which may be associated with increased risk for suicidal behavior directly and indirectly through relationship disruptions.
  • Altered amygdala circuits underlying valence processing among manic and
           depressed phases in bipolar adults
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Vincent Man, June Gruber, David C. Glahn, William A. Cunningham BackgroundDisruptions in affective processing characterize mood disorders, yet the neural mechanisms underlying internal state dependency in affective processes are not well understood. The present work presents a pilot investigation into state dependency among neural circuits known to be involved in processing affective information, by examining acute manic and depressive mood phases in adults with bipolar disorder and major depressive disorder.MethodsThe present study probed affective processes with a well-validated passive picture-viewing task amongst acutely manic (n = 8) or acutely depressed (bipolar depression: n = 11; major depression: n = 15) mood-disordered adults during functional magnetic resonance imaging .ResultsBeta-series correlation analyses seeded from the amygdala revealed distinct neural circuits distinguished across current mood state rather than diagnostic boundaries. We delineated an amygdala-striatum pathway that distinguished depressed from manic mood phase, rather than between diagnostic boundaries, in processing valenced information. Specifically, we found differences in this neural response to negative, but not positive, images across clinical mood states.LimitationsAs a preliminary investigation of state-dependent affective processes, the current investigation is predominantly limited by the small sample size. While it provides direction and generates hypotheses for further work, future studies need to replicate and expand the reported effects with larger samples.ConclusionsThese findings demonstrate the conditions under which mood state-dependent affective processes cut cross traditional diagnostic boundaries, speaking to recent advances in transdiagnostic disease mechanisms, and can guide future work examining the neural mechanisms driving symptomatology in affective disorders.
  • Effect of bifidobacterium breve A-1 on anxiety and depressive symptoms in
           schizophrenia: A proof-of-concept study
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Ryo Okubo, Minori Koga, Noriko Katsumata, Toshitaka Odamaki, Shiina Matsuyama, Matsuhiko Oka, Hisashi Narita, Naoki Hashimoto, Ichiro Kusumi, Jinzhong Xiao, Yutaka J. Matsuoka BackgroundStudies of probiotics have suggested they have a positive effect on anxiety and depressive symptoms in humans. This study investigated the effect of consuming the probiotic Bifidobacterium breve A-1 on anxiety and depressive symptoms in patients with schizophrenia and explored its effect on immune products such as cytokines and chemokines.MethodsIn this open-label single-arm study, all participants received B. breve strain A-1 (1011 cfu/day) for 4 weeks followed by 4 weeks of observation. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) score. Secondary outcomes were anxiety and depressive symptoms on the Positive and Negative Syndrome Scale (PANSS), blood test findings, and fecal microbiome composition.ResultsTwenty-nine outpatients completed the study. HADS total score and PANSS anxiety/depression score were significantly improved at 4 weeks. Based on the criterion of a greater than 25% reduction in HADS total score at 4 weeks from baseline, there were 12 responders and 17 non-responders. Responders were found to have fewer negative symptoms, reduced intake of dairy products, and higher relative abundance of Parabacteroides in the gut microbiome than non-responders. Moreover, IL-22 and TRANCE expression was significantly increased at 4 weeks from baseline in responders but not in non-responders.LimitationsThis open-label, single-arm study cannot exclude a placebo effect.ConclusionsThe results suggest the potential effect of B. breve A-1 in improving anxiety and depressive symptoms in patients with schizophrenia. Further studies should investigate this effect in patients with other psychiatric conditions and assess dietary habits and the gut microbiome.
  • A key for perinatal depression early diagnosis: The body dissatisfaction
    • Abstract: Publication date: 15 February 2019Source: Journal of Affective Disorders, Volume 245Author(s): Riquin Elise, Lamas Claire, Nicolas Isabelle, Dugre Lebigre Corinne, Curt Florence, Cohen Henri, Legendre Guillaume, Corcos Maurice, Godart Nathalie ObjectiveTo test if the evaluation of body dissatisfaction by images could be an interesting tool to detect perinatal depression early in pregnancy, questioning patients about their body image instead of their depressive symptoms.MethodsA sample of 457 women was recruited in a longitudinal study. Three evaluations were performed at the 4th and 8th months of pregnancy and during post-partum. During these evaluations, sociodemographic data were collected and psychiatric scales were completed, including Edinburgh Postnatal Depression Scale (EPDS), Eating Disorder Examination-Questionnaire (EDE-Q), Pictorial Body Image Scale (PBIS) and Body Shape Questionnaire (BSQ).Results33% of the women who were unsatisfied with their body image suffered from perinatal depression vs. 11.3% of the women who were not (p 
  • Omega-3 polyunsaturated fatty acids and psychological intervention for
           workers with mild to moderate depression: a double-blind randomized
           controlled trial
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): J. Tayama, S. Ogawa, N. Nakaya, T. Sone, T. Hamaguchi, A. Takeoka, K. Hamazaki, H. Okamura, J. Yajima, M. Kobayashi, M. Hayashida, S. Shirabe BackgroundThis study assessed whether a combined intervention of omega-3 polyunsaturated fatty acids (PUFAs) and psychoeducation better improved mild to moderate depression in workers compared to psychoeducation alone.MethodsThis study was a double-blinded, parallel group, randomized controlled trial that compared the intervention group, receiving omega-3 fatty acids, with a control group, receiving a placebo supplement. Participants receiving omega-3 fatty acids took 15 × 300 mg capsules per day for 12 weeks. The total daily dose of omega-3 PUFAs was 500 mg docosahexaenoic acid and 1000 mg eicosapentaenoic acid (EPA). The Beck Depression Inventory®-II (BDI-II) was used to assess the severity of depression after treatment.ResultsAfter 12 weeks of treatment, BDI-II scores were significantly lower in the placebo and omega-3 group, when compared to their respective baseline scores (Placebo: t = −4.6, p < 0.01; Omega-3: t = −7.3, p < 0.01). However, after 12 weeks of treatment, we found no significant difference between both groups with respect to changes in the BDI-II scores (0.7; 95% CI, −0.7 to 2.1; p = 0.30).LimitationsThis study did not measure blood omega-3 fatty acid concentration and presented a high-dropout rate. Moreover, our results may not be generalizable to other regions.ConclusionsThe results show that a combination of omega-3 fatty acids and psychoeducation and psychoeducation alone can contribute to an improvement in symptoms in people with mild to moderate depression. However, there is no difference between the interventions in ameliorating symptoms of depression.
  • The effect of complementary medicines and therapies on maternal anxiety
           and depression in pregnancy: a systematic review and meta-analysis
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): Caroline A. Smith, Zewdneh Shewamene, Megan Galbally, Virginia Schmied, Hannah Dahlen BackgroundDepression and anxiety are common during the antenatal and postnatal period, and are known to have a significant impact on the woman and her unborn infant. Pregnant women state a preference for non-pharmacological treatment options, and use complementary medicines and therapies to manage these symptoms. We examined the effectiveness and safety of these modalities on depression and anxiety during pregnancy.MethodsCENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials comparing complementary therapies and medicines to a control, for pregnant women with depression or anxiety. The primary outcome measure was antenatal depression or anxiety.ResultsTwenty randomised controlled trials containing 1,092 women were included in the review. We found some evidence of reduced antenatal depression from three modalities. Acupuncture reduced the number of women diagnosed with antenatal depression (RR 1.68, 95% CI 1.06 to 2.66, 1 trial). Massage reduced the severity of antenatal depression in one trial of 149 women (SMD -0.73, 95%CI -1.07 to -0.39). One small trial of bright light therapy found reduced antenatal depression (RR 4.80, 95% CI -8.39 to -1.21, 27 women). There was no evidence of a reduction in depression and anxiety from relaxation, yoga, mindfulness and fish oils. Overall the risk of bias was high or unclear for the majority of studies.LimitationsThere are few high quality randomised controlled trials of complementary medicines and therapies examining the effect on anxiety and depression.ConclusionAcupuncture, bright light therapy, and massage may reduce antenatal depression. There is a need for high quality and larger studies that include postnatal follow up and maternal and neonatal outcomes.
  • Digging deeper in the differential effects of inflammatory and
           psychosocial stressors in remitted depression: effects on cognitive
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): Peter Niemegeers, Peter De Boer, Jeroen Schuermans, Glenn J.H. Dumont, Violette Coppens, Kurt Spittaels, Stephan Claes, Bernard G.C. Sabbe, Manuel Morrens BACKGROUNDMajor Depressive Disorder (MDD) covers a wide spectrum of symptoms, including cognitive dysfunction, which can persist during remission. Both inflammatory states and psychosocial stress play a role in MDD pathogenesis.METHODSThe effects of inflammatory (i.e. Salmonella typhi vaccine) and psychosocial stressor (i.e. Trier Social Stress Test), as well as their combination were investigated on cognition in women (aged 25-45 years, n = 21) with (partially) remitted MDD and healthy controls (n = 18) in a single-blind placebo-controlled study. In a crossover design, patients received on the first day one of the aforementioned interventions and on the other day a placebo, or vice versa, with a washout period of 7-14 days. Short-term and verbal memory, working memory, attention, verbal fluency, information processing speed, psychomotor function, and measures of attentional bias to emotions were measured. Exploratory analyses were performed to assess the correlation between biomarkers of inflammation and the Hypothalamic-Pituitary-Adrenal axis and cognitive functioning.RESULTSIn patients, inflammatory stress decreased information processing speed and verbal memory, and increased working memory; after psychosocial stress, there was an increase in attention. There was also an increased negative attentional bias in patients after inflammatory stress. Neither stressor had any effect in controls.LIMITIATIONSLimitations are the relatively small sample size and antidepressant use by a part of the participants. The effects of the stressors were also measured a relatively short period after administration.CONCULSIONPatients were sensitive to the cognitive effects of inflammation and psychosocial stress on cognition, while controls were not.
  • Sugar-sweetened beverages consumption and the risk of depression: A
           meta-analysis of observational studies
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): Danqing Hu, Lixiao Cheng, Wenjie Jiang BackgroundIt remains inconsistent whether sugar-sweetened beverages (SSBs) consumption increases the risk of depression. Thus, we carried out a meta-analysis to evaluate the association between SSBs consumption and the risk of depression.MethodsPubMed and Web of Science were searched for relevant articles published up to June 2018. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by the fixed-effects model or random effect model based on heterogeneity test.Results10 observational studies involving 37131 depression cases among 365289 participants were included. The combined risk of depression for the highest versus lowest consumption of SSBs was 1.31 (95% CI 1.24-1.39). The findings were consistent in the cross-sectional studies (RR = 1.38; 95% CI 1.26-1.52) as well as in the cohort studies (RR = 1.30; 95% CI 1.19-1.41) A nonlinear dose-response relationship was found (Pnonlinearity = 0.0103) for depression risk and SSBs consumption. Compared with SSBs nondrinkers, those who drank the equivalent of 2 cups/day of cola might increase the risk of depression by 5% (RR = 1.05; 95% CI 1.01–1.09). And the equivalent of 3cans/day of cola might have approximately 25% higher risk of depression.Limitations10 studies were included in this meta-analysis, of which only 4 were cohort studies, and more cohort studies need to be performed in the future.ConclusionsThis meta-analysis indicates that SSBs consumption might be associated with a modestly higher risk of depression. The results need to be further confirmed in the future.
  • Inflammatory DEpression Advances in Schizophrenia (IDEAS): a precision
           medicine approach of the national FACE-SZ cohort
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): G. Fond, O. Godin, F. Schürhoff, F. Berna, B. Aouizerate, D. Capdevielle, I. Chereau, T. D'Amato, C. Dubertret, J. Dubreucq, C. Faget, S. Leignier, C. Lançon, J. Mallet, L. Marulaz, D. Misdrahi, C. Passerieux, R. Rey, A. Schandrin, M. Urbach BackgroundMajor Depressive Disorder (MDD) is a therapeutic challenge in schizophrenia (SZ). Untangling different forms of MDD appears as the best current strategy to improve remission to treatment in the so-called precision medicine approach.AimsThe objectives of the present study were to determine (i) the prevalence of Inflammatory Depression (ID) in stabilized SZ outpatients (ii) if ID was associated with clinical or cognitive profiles that may help clinicians detecting ID (iii) if antidepressants were effective in ID and (iv) the biological correlates of ID that may orientate personalized treatments.MethodParticipants were consecutively included and received a thorough 2 days- clinical assessment.Results785 subjects were recruited in the FACE-SZ cohort. 289 (36.8%) were diagnosed with MDD (remitted or unremitted), of them 57 with ID (19.7%). No clinical or cognitive features were associated with ID (all p>0.05). ID has been associated with increased abdominal perimeter (aOR=4.48, p=0.002) and latent Toxoplasma infection (aOR=2.19, p=0.04). While antidepressants were associated with decreased depressive symptoms level in ID, 44% of the subjects remained unremitted under antidepressant, with no association with CRP blood levels.ConclusionsID may not differ from other forms of depression by its clinical symptoms but by its aetiologies. ID is associated with increased perivisceral fat and latent Toxoplasma infection that are both potentially related to gut/microbiota disturbances. Specific anti-inflammatory drugs and microbiota-targeted therapeutics appear as promising strategies in the treatment of inflammatory depression in schizophrenia.
  • Depression disorder in patients with cerebellar damage: awareness of the
           mood state.
    • Abstract: Publication date: Available online 6 November 2018Source: Journal of Affective DisordersAuthor(s): Silvia Clausi, Michela Lupo, Giusy Olivito, Libera Siciliano, Maria Pia Contento, Fabio Aloise, Luigi Pizzamiglio, Marco Molinari, Maria Leggio Background: Although depressive symptoms are often reported to be comorbid with degenerative cerebellar diseases, the role of the cerebellum in depressive disorder needs to be elucidated. To address this aim, we investigated self-perception of the negative mood state in patients with cerebellar pathology and depressive symptoms.Methods: Thirty-eight patients with cerebellar damage (10 with depressive symptoms – CB-DP and 28 with no depressive symptoms – CB-nDP), 11 subjects with depressive disorders without cerebellar damage (DP) and 29 healthy controls (CTs) were enrolled. A device for self-monitoring of the mood state (MoMo) and validated scales such as the Profile of Mood States questionnaire (POMS), the Self-Report Symptom Inventory-Revised (SCL-90-R) and the Hamilton Depression Rating Scale (HDRS) were used to evaluate depressive symptoms.Results: Both CB-DP and DP patients showed higher scores than CTs on the POMS and SCL-90-R for depressive factors and on the HDRS. DP patients showed a lower frequency of ‘good’ mood and a higher frequency of ‘bad’ mood than CTs when using the MoMo device. However, although the two depressed populations showed comparable scores on these validated scales, CB-DP patients showed impaired self-awareness of the mood experience in ‘the here and now’, as evidenced by the absence of significant differences, compared with CTs, in the subjective mood evaluation performed with the MoMo device.Limitations: The number of CB patients and inhomogeneity across MRI scans were study limitations.Conclusion: Cerebellar dysfunction might slow the data integration necessary for mood state awareness, resulting in difficulty of depressed CB patients in explicitly recognizing their mood “in the here and now”.
  • Desvenlafaxine vs. placebo in the treatment of persistent depressive
    • Abstract: Publication date: Available online 5 November 2018Source: Journal of Affective DisordersAuthor(s): David J. Hellerstein, Jonathan W. Stewart, Ying Chen, Vinushini Arunagiri, Bradley S. Peterson, Patrick J. McGrath IntroductionPharmacotherapy of non-major persistent depressive disorder (PDD) is little studied. We report a study of the serotonin-norepinephrine reuptake inhibitor (SNRI) desvenlafaxine (DVLX) for PDD.MethodNon-psychotic, non-bipolar outpatients aged 20-65 having PDD without concurrent major depression (MDD) were randomized double-blind to desvenlafaxine or placebo for 12 weeks. All had Hamilton Depression Rating Scale (HDRS-24) score ≥12. Open-label DVLX was offered for 12 weeks following the acute trial.ResultsSeventy-one subjects having mean baseline HDRS-24 20.27±4.77 were eligible, of whom post-RZ data was available for all 59 randomized. The primary 12 week analysis did not differentiate DVLX-treated subjects’ mean HDRS scores from those on placebo (6.53 ± 3.98 vs. 8.24 ± 4.96, F=3.33, df=1, p=.07). Several secondary analyses yielded statistically significant results, including Responder, CGI and QIDS.DiscussionAs the primary analysis did not reach statistical significance, this is a negative study which does not support the use of DVLX for non-major PDD. Nevertheless, statistically significant secondary analyses suggest the overall negative result could be due to sample size or sampling, suggesting further studies of this medication might be appropriate in this population.
  • Depression symptomology groups among middle and older adult emergency
           department patients
    • Abstract: Publication date: Available online 5 November 2018Source: Journal of Affective DisordersAuthor(s): Ashley Holub, Joseph Lee, Vincent DeRienzo, Flavia Nobay, Beau Abar IntroductionMiddle and late life adults may present depression symptomology differently than the expected symptoms of depression. Clusters of common symptoms may be overlooked when determining the most appropriate treatment options, leading to a less than effective treatment. Investigation of these clusters is needed to better understand patterns of depressive symptomology among middle and late life adults.MethodsConsent, demographics, self-report items and PHQ-9 items were administered to subjects. Latent class analysis (LCA), was used to determine groupings of patients based on PHQ-9 items. Demographics were compared across classes for additional information.ResultsA total of 252 subjects aged 45-85 years old were enrolled. A LCA indicated that a 3 class solution explained the clusters endorsed: Low Concerns (35%), Many Concerns (34%), and Sleep and Fatigue Concerns (31%). Patients in the Low Concerns class were more likely to have private insurance compared to those in the Many Concerns class (57% vs 34%, p = 0.003). They also reported better general health (M = 2.39 vs M = 1.58, p < 0.001), and visited their PCP less frequently (M = 1.64 visits vs M = 3.31 visits, p = 0.004).LimitationsRecall bias may have been present due to self-report of symptoms which was report was based on a low threshold for endorsement of items. Future larger studies should utilize more response options.ConclusionLCA suggests there are three unique groupings of symptoms as reported by the PHQ-9. These clusters may be valuable in determining treatment options and designing interventions.
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